Biocor No- React stentless aortic valve--short-term results.

Area of Science:

• Cardiovascular Surgery
• Biomaterials Science
• Medical Devices

Background:

• Anticoagulation is often contraindicated or poorly tolerated in specific patient groups requiring aortic valve replacement.
• Stentless bioprosthetic valves offer a potential alternative to mechanical valves, aiming to reduce complications associated with long-term anticoagulation.

Purpose of the Study:

• To evaluate the short-term clinical outcomes of the Biocor No-React composite porcine stentless aortic valve.
• To assess the safety and efficacy of this valve in patients with contraindications or non-compliance to anticoagulation.

Main Methods:

• A retrospective review of 52 consecutive patients who received the Biocor No-React stentless aortic valve between September 1994 and May 1998.
• Analysis included patient demographics, surgical procedures, early mortality, functional status (New York Heart Association class), echocardiographic findings, and long-term survival and event-free survival.

Main Results:

• Early mortality was 5.8%, associated with pre-operative ejection fraction, NYHA class, and bacterial endocarditis.
• 84% of survivors were in NYHA class I or II at discharge. Postoperative peak gradient was 19.9 mmHg.
• Aortic regurgitation was mild in 36.6% of cases, resolving in 10. Widening of the non-coronary sinus occurred in 52% of cases, possibly related to aortotomy technique. Patient survival was 88.5% and event-free survival was 80.0% at 4 years.

Conclusions:

• The Biocor No-React stentless aortic valve provides acceptable short-term results in a young, predominantly third-world population.
• Outcomes appear superior to mechanical valves in similar patient cohorts.
• A transverse aortotomy above the sinotubular ridge is recommended for stentless aortic valve implantation.