<p><strong>Aim.</strong> The paper aims to assess the quality of life of patients subjected to aortic valve replacement with a stented/stentless biological prosthesis. <br /><strong>Methods.</strong> The research was done at the Acquired Heart Disease Department of Meshalkin National Medical Research Center. The inclusion criteria were patient age older than 65 years and severe stenosis of the aortic valve. 114 patients were randomized 1:1 in two groups: group I patients received stentless biological prostheses, while group II patients — stented xenopericardial ones. All patients underwent aortic valve replacement under normothermic cardiopulmonary bypass. Mean follow-up was 3.9 [2.77; 4.55] years, mean age 71.5±4 (65–84) years, mean left ventricle ejection fraction 65.5 (40–86) % and mean preoperative Log.Euroscore 5.4±1.3 (1.4–12.4). The quality of life was assessed by using a standard questionnaire SF-36.<br /><strong>Results.</strong> Peak transprosthetic gradients at 1-year follow-up amounted to 16.22±4.34 and 24.66±4.74 mm Hg for group I and group II respectively. The 5-year survival rate was 90 [81; 99] % and 96 [90; 100] % for the two groups respectively and did not differ statistically (log rank test, p = 0.226). A statistically significant improvement of quality of life among patients in both groups was observed at 1-year follow-up, as compared to the preoperative values, however, marked intergroup differences in any of the parameters were not recorded.<br /><strong>Conclusion.</strong> The quality of life after aortic valve replacement with stented and stentless biological prostheses in elderly patients confirms clinical and functional efficiency of both methods, does not show sound advantages of any of them and improves both the physical component of health and subjective emotional level.</p><p>Received 25 July 2017. Revised 18 August 2017. Accepted 28 August 2017.</p><p><strong>Funding:</strong> The study was carried out with the support of a grant of the President of the Russian Federation (МД–6967.2016.7) created to provide government assistance to the leading research centers in Russian Federation.</p><p><strong>Conflict of interest:</strong> The authors declare no conflict of interest.</p>

<p><strong>Aim.</strong> The study was designed to comparatively assess dynamic changes of the aortic root structures depending on a phase of the cardiac cycle in patients with degenerative aortic stenosis, who underwent aortic valve replacement with different types of biological prostheses.<br /><strong>Methods.</strong> This prospective parallel controlled randomized trial study was performed at Meshalkin National Medical Research Center over a period from 2011 to 2015. The inclusion criteria were severe aortic stenosis and patients’ age older than 65 years. 114 patients were randomized 1:1 in two groups: group I included 57 patients with stentless biological prostheses, while group II (control one) consisted of 57 patients with stented xenopericardial prostheses. The average age was 71 [66; 74] and 72 [69; 77] for the first and second groups, respectively (p = 0.054). All patients underwent aortic valve replacement. The operation was performed under standard normothermic cardiopulmonary bypass. The diameter of the implanted prostheses was 25 mm [24; 26] and 23 mm [21; 23] for the first and second groups, respectively (p = 0.375). An ECG-synchronized CT study of the aortic root was carried out in the postoperative period.<br /><strong>Results.</strong> An intergroup systolic/diastolic difference in the values of the cross-sectional area of the aortic root at all levels was observed in patients with stentless bioprostheses, while the control group patients (with stented bioprostheses) had no such difference at the levels of the left ventricle output tract and the fibrous ring of the aortic valve.<br /><strong>Conclusion.</strong> A stentless design of bioprostheses retains the deformational and elastic properties of the aortic root in elderly patients with aortic valve stenosis after surgical treatment.</p><p>Received 5 December 2017. Revised 12 December 2017. Accepted 15 December 2017.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> The authors declare no conflict of interest.</p><p><strong>Author contributions</strong><br />Conception and study design: D.P. Demidov, D.A. Astapov, A.V. Bogachev-Prokophiev<br />Data collection and analysis: D.P. Demidov<br />Drafting the article: D.P. Demidov<br />Critical revision of the article: D.A. Astapov, A.V. Bogachev-Prokophiev<br />Final approval of the version to be published: D.A. Astapov, A.V. Bogachev-Prokophiev, S.I. Zheleznev, A.M. Karaskov</p>