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Hemodynamic performance after stented vs stentless aortic valve replacement.

M J Jasinski1, J Hayton, Z Kadziola

  • 1Glenfield General Hospital, Leicester, UK. Marekjas@hotmail.com

The Journal of Cardiovascular Surgery
|June 11, 2002
PubMed
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Stentless bioprosthetic valves demonstrate improved hemodynamics compared to stented valves, with lower peak flow velocity and reduced transvalvular gradient. However, both valve types showed comparable left ventricular mass reduction one year post-surgery.

Area of Science:

  • Cardiovascular Surgery
  • Biomedical Engineering
  • Cardiac Physiology

Background:

  • Stentless bioprostheses are hypothesized to offer superior hemodynamics and longevity over stented counterparts.
  • This study compares the echocardiographic performance of the stentless Freestyle and stented Mosaic bioprosthetic valves.
  • Similarities in fixation and anticalcification technology suggest differences may stem from the stent itself.

Purpose of the Study:

  • To compare the hemodynamic performance and left ventricular remodeling of stentless versus stented bioprosthetic aortic valves.
  • To evaluate echocardiographic parameters including peak flow velocity, transvalvular gradient, effective orifice area, and left ventricular mass.

Main Methods:

  • A randomized trial involving 28 patients undergoing aortic valve replacement (AVR).

Related Experiment Videos

  • Patients received either a stented or stentless bioprosthetic valve.
  • Echocardiograms (M-mode and Doppler) were conducted at baseline, early post-op, 3-6 months, and 1 year.

    • Main Results:

    • Stentless valves exhibited significantly lower peak flow velocity and mean transvalvular gradient, particularly at 1 week and 6 months.
    • Effective orifice area remained stable in both groups.
    • Aortic valve velocity time integral increased in the stentless group.
    • Left ventricular mass decreased significantly in both groups, with comparable reduction degrees.

    Conclusions:

    • Stentless bioprosthetic valves offer significant hemodynamic advantages over stented valves.
    • Despite hemodynamic benefits, stentless valves did not result in a greater degree of left ventricular mass reduction within the first year post-surgery.