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Related Experiment Videos

Stentless aortic valve replacement in elderly patients.

S Gelsomino1, P Da Col, G Morocutti

  • 1Department of Cardiovascular Sciences, General Hospital 'S. Maria della Misericordia', Udine, Italy. sandrogelsomino@virgilio.it

Cardiovascular Surgery (London, England)
|June 5, 2002
PubMed
Summary

The Cryolife O'Brien (CLOB) stentless bioprosthesis demonstrated satisfactory clinical outcomes and hemodynamic improvements in elderly patients over seven years. This aortic valve substitute showed good survival rates and reduced left ventricular mass index.

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Area of Science:

  • Cardiovascular Surgery
  • Bioprosthetic Heart Valves
  • Geriatric Cardiology

Background:

  • The Cryolife O'Brien (CLOB) stentless bioprosthesis is a type of aortic valve replacement.
  • Elderly patients (>75 years) often present with aortic valve disease requiring surgical intervention.
  • Long-term outcomes of bioprosthetic valves in this specific demographic are crucial for clinical decision-making.

Purpose of the Study:

  • To report the seven-year clinical and hemodynamic results of the CLOB stentless bioprosthesis.
  • To evaluate the efficacy and safety of the CLOB valve in elderly patients undergoing aortic valve implantation.
  • To assess changes in hemodynamic parameters and left ventricular remodeling post-implantation.

Main Methods:

  • A cohort of 36 patients aged over 75 years received a CLOB bioprosthesis in the aortic position between 1993 and 2000.

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  • Serial echocardiograms were performed preoperatively, at discharge, and at regular intervals up to seven years post-implantation.
  • Clinical outcomes including survival and hemodynamic parameters were monitored throughout the follow-up period.

    • Main Results:

    • The 30-day mortality rate was 2.4% (1 patient).
    • Actuarial survival rates at seven years were high (94.8+/-2.0%).
    • Significant improvements were observed in hemodynamic function, including reduced gradients and increased effective orifice area index, along with a substantial reduction in left ventricular mass index.

    Conclusions:

    • The CLOB stentless bioprosthesis proved to be a satisfactory valve substitute in elderly patients.
    • The study supports the use of the CLOB xenograft for aortic valve replacement in geriatric populations.
    • Positive long-term clinical and hemodynamic performance was demonstrated in this cohort.