Comparison of implantation techniques using freestyle stentless porcine aortic valve

Kon, Neal D.; Westaby, Stephen; Amarasena, Naomali; Pillai, Ravi; Cordell, A. Robert

doi:10.1016/0003-4975(95)00066-t

Cited by 72 publications

(31 citation statements)

References 19 publications

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“…But implantation of stentless valves is more complex than stented valves, requir-ing longer cardiopulmonary bypass and ischemic times. 5 Previous studies comparing the effect of stentless and stented valves on LV mass regression after AVR have shown conflicting results. 6 -12 Despite this, there is a general belief that greater relief of valve orifice narrowing relates to a more favorable outcome.…”

mentioning

confidence: 99%

Randomized Comparison of Stentless Versus Stented Valves for Aortic Stenosis

et al. 2005

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on behalf of the ASSERT (Aortic Stentless versus Stented valve assessed by Echocardiography Randomized Trial) InvestigatorsBackground-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. Methods and Results-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 Յ25 mm in diameter were randomly allocated to a stentless (nϭ93) or a stented supra-annular (nϭ97) valve. There were no significant differences in mean LVMI between the stentless versus stented groups at baseline (176Ϯ62 and 182Ϯ63 g/m 2 , respectively) or at 6 months (142Ϯ49 and 131Ϯ45 g/m 2 , respectively), although within-group changes from baseline to 6 months were highly significant. Changes in LVMI measured by cardiovascular MR (nϭ38) were consistent with the echo findings. There was a greater reduction in peak aortic velocity (PϽ0.001) and a greater increase in indexed effective orifice area (PϽ0.001) in the stentless group than in the stented group. There were no differences in clinical outcomes between the 2 valve groups. Conclusions-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. (Circulation. 2005;112:2696-2702.)

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confidence: 99%

Randomized Comparison of Stentless Versus Stented Valves for Aortic Stenosis

et al. 2005

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“…12,15 The excellent postoperative hemodynamic performance demonstrated by the stentless bioprosthesis in this study corresponded with the results of other studies. [2][3][4][5][6][7][8][9][10][11][12] There are three different types of implantation technique of stentless bioprosthesis, such as full root replacement, root inclusion technique, and subcoronary technique. The subcoronary technique is most frequently used probably because of the possibility of the development of aortic wall calcification that would make any subsequent reoperation complicated.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9][10][11] Although a modified subcoronary technique has been mainly used as the surgical technique for valve implantation in this procedure, [2][3][4] we have performed full root replacement using a freestyle aortic root bioprosthesis (Medtronic, Minneapolis, MN, USA), especially in elderly patients with severe aortic stenosis. 12 This approach allowed us to replace valves with a larger orifice and also to maintain the integrity of the aortic root leading to a lesser gradient across the aortic valve, thus resulting in a lower risk of postoperative aortic regurgitation (AR).…”

Section: Introductionmentioning

confidence: 99%

Surgical Experience of Full Root Replacement with Freestyle Bioprosthesis: Indications, Surgical Technique, and Results

et al. 2004

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“…In order to reduce the risk of bioprosthetic valve distortion during implantation potentially leading to valve regurgitation [27] or accelerated deterioration [28], the stentless bioprosthesis can alternatively be implanted using the fullroot method. Although this allows for easy and reproducible replacement of the aortic root [29,30], the commercially available stentless bioprostheses are usually too short to replace the ascending tubular aorta.…”

Section: The Full-root With Graft Extension Techniquementioning

confidence: 99%

Bioprosthetic replacement of the ascending thoracic aorta: what are the options?

Kirsch¹,

Ōoka²,

Zannis³

et al. 2009

European Journal of Cardio-Thoracic Surgery

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Increasing patient age and improved durability of latest generation bioprostheses have stimulated the use of bioprosthetic devices in the setting of ascending aortic replacement as an alternative to mechanical valved conduits or aortic valve-sparing procedures. We performed an English literature review to assess different surgical options that have been described for bioprosthetic replacement of the ascending aorta. Reported options include: (1) composite valved conduits using a stented bioprosthesis; (2) composite valved conduits using a stentless bioprosthesis; (3) total xenopericardial valved conduits. Composite valved grafts using stented bioprostheses offer a safe and durable option for bioprosthetic replacement of the ascending aorta. Other options are of more recent use and await medium-term results.

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Comparison of implantation techniques using freestyle stentless porcine aortic valve

Cited by 72 publications

References 19 publications

Randomized Comparison of Stentless Versus Stented Valves for Aortic Stenosis

Randomized Comparison of Stentless Versus Stented Valves for Aortic Stenosis

Surgical Experience of Full Root Replacement with Freestyle Bioprosthesis: Indications, Surgical Technique, and Results

Bioprosthetic replacement of the ascending thoracic aorta: what are the options?

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