Are stentless valves hemodynamically superior to stented valves? A prospective randomized trial.

摘要: Abstract Background . Although stentless aortic bioprostheses are believed to offer improved outcomes, hemodynamic benefits remain unsubstantiated. Methods Fifty-three patients were randomized receive the stented C-E pericardial valve (CE) and 46 Toronto Stentless Porcine (SPV). Annuli sized for optimal insertion of both types, such that surgeons required commit specific sizes before randomization. Echocardiographic measurements functional status (Duke Activity Status Index) assessed at 3 12 months postoperatively. Results cardiopulmonary bypass times (CE: 118.6 ± 36.3 minutes; SPV: 148.5 30.9 p = 0.0001) cross-clamp 95.4 28.6 123.6 24.1 significantly prolonged in SPV group, perioperative morbidity mortality was similar between groups. Neither offered a superior internal diameter any given annular (mean decrease left ventricular outflow tract after valvular implantation: 3.4 1.11 mm versus CE: 3.7 1.33 mm;E 0.25). labeled mean size larger actual based on no different groups 21.9 2.0 mm; 22.3 0.286). effective orifice areas increased, peak transvalvular gradients decreased over time, differences demonstrated months. Similarly, although significant regression mass accomplished Finally, Duke Index scores time; however, noted Conclusions offering excellent valves did not demonstrate indices comparison up implantation.