Early recovery of left ventricular function after stentless versus stented aortic valve replacement for pure aortic stenosis and severe cardiac dysfunction

Semin Thorac Cardiovasc Surg. 2001 Oct;13(4 Suppl 1):120-8.

Abstract

Objective: The aim of this study was to evaluate early recovery of systolic function after stentless aortic valve replacement (AVR) versus stented AVR.

Methods: Fifty-four consecutive patients with pure aortic stenosis and impaired left ventricular function (LVEF < or = 35%) were studied retrospectively. Aortic regurgitation, concomitant valvular or coronary artery surgery, atrial fibrillation, and a previous AVR were exclusion criteria. Twenty-two patients (mean age, 70.0 +/- 6.5 years) received a stentless bioprosthesis and 32 (mean age, 58.9 +/- 6.2 years, P =.031 between groups) a mechanical or stented biologic valve. Patients underwent echocardiography preoperatively, at discharge, at 6 months, and at 1 year after surgery.

Results: At 6 months, analysis of variance demonstrated significant differences between groups in fractional shortening measured at the endocardium and midwall fractional shortening (<0.001), velocity of circumferential shortening (P <.001) ejection fraction (P =.02), left ventricular mass index (P <.001), systolic meridional wall stress, and circumferential wall stress (P <.001), One-year studies confirmed these findings.

Conclusion: LV function showed, after a stentless AVR, an early recovery greater than in patients receiving a stented valve.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Aged
  • Aortic Valve / diagnostic imaging*
  • Aortic Valve / surgery
  • Aortic Valve Stenosis / physiopathology
  • Aortic Valve Stenosis / surgery*
  • Body Surface Area
  • Echocardiography
  • Female
  • Heart Valve Prosthesis*
  • Humans
  • Male
  • Middle Aged
  • Prosthesis Design
  • Systole
  • Time Factors
  • Ventricular Dysfunction, Left / physiopathology
  • Ventricular Dysfunction, Left / surgery*
  • Ventricular Function, Left / physiology*