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DOI: 10.1055/s-0034-1367231
Hemodynamic behavior of stentless aortic valves in long term follow-up
Objectives: A retrospective long-term evaluation of aortic porcine stentless valves in patients ≤60 years and its impact on the left ventricle.
Methods: 7 to 16 years after aortic valve replacement, 54 patients (mean age at operation 53.1 ± 7.7 years) received echocardiography and clinical examination. Mean follow-up time was 10.8 ± 2.2 years. Evaluated were gradients, left ventricular mass and function and NYHA class.
Results: At follow-up only one patient presented with NYHA class III. All other patients were in NYHA class I or II. Maximum and mean pressure gradients of prostheses were 16.3 ± 7.4 mmHg and 9.1 ± 4.2 mmHg, respectively. Compared to echocardiography at discharge mean pressure gradients dropped 18.0% (2.0 ± 0.9 mmHg). During the study interval pressure gradients did not change significantly. Only 5 patients showed relevant insufficiencies (at 13-16 years after valve replacement), 49 showed no or trivial insufficiencies. Left ventricular mass decreased 26.5% (107.9 ± 18.5 g) and did not change significantly during follow-up (Fig. 1). Left ventricular function increased in 17 patients and decreased in only one patient. For patients with preoperatively impaired left ventricular function an increase of 13.1 ± 3.1% was seen (Fig. I).
Fig. 1 Left ventricular function and mass
Conclusion: Porcine stentless aortic valves provide excellent hemodynamic long-term results without significant rise of transvalvular pressure gradients until 14 years leading to sustained decrease of left ventricular mass and improvement of left ventricular function.