Details

Autor(en) / Beteiligte

• PEREZ DE ARENAZA, Diego
• LEES, Belinda
• GUVENDIK, Levant
• BOCHENEK, Andrzej
• WOS, Stanislaw
• LIE, Mons
• VAN NOOTEN, Guido
• PENNELL, Dudley
• PEPPER, John
• FLATHER, Marcus
• NUGARA, Fiona
• HUSEBYE, Trygve
• JASINSKI, Marek
• CISOWSKI, Marek
• KHAN, Mohammed
• HENEIN, Michael
• GAER, Jullien

Titel

Randomized comparison of stentless versus stented valves for aortic stenosis : Effects on left ventricular mass

Ist Teil von

• Circulation (New York, N.Y.), 2005-10, Vol.112 (17), p.2696-2702

Ort / Verlag

Hagerstown, MD: Lippincott Williams & Wilkins

Erscheinungsjahr

2005

Quelle

MEDLINE

Beschreibungen/Notizen

• Aortic valve replacement (AVR) is the established treatment for severe aortic stenosis. In response to the long-term results of aortic homografts, stentless porcine valves were introduced as an alternative low-resistance valve. We conducted a randomized trial comparing a stentless with a stented porcine valve in adults with severe aortic stenosis. The primary outcome was change in left ventricular mass index (LVMI) measured by transthoracic echocardiography and, in a subset, by cardiovascular MR. Measurements were taken before valve replacement and at 6 and 12 months. Patients undergoing AVR with an aortic annulus < or =25 mm in diameter were randomly allocated to a stentless (n=93) or a stented supra-annular (n=97) valve. There were no significant differences in mean LVMI between the stentless versus stented groups at baseline (176+/-62 and 182+/-63 g/m2, respectively) or at 6 months (142+/-49 and 131+/-45 g/m2, respectively), although within-group changes from baseline to 6 months were highly significant. Changes in LVMI measured by cardiovascular MR (n=38) were consistent with the echo findings. There was a greater reduction in peak aortic velocity (P<0.001) and a greater increase in indexed effective orifice area (P<0.001) in the stentless group than in the stented group. There were no differences in clinical outcomes between the 2 valve groups. Despite significant differences in indexed effective orifice area and peak flow velocity in favor of the stentless valve, there were similar reductions in left ventricular mass at 6 months with both stented and stentless valves, which persisted at 12 months.