Ten-Year Experience With Stentless Aortic Valves: Full-Root Versus Subcoronary Implantation
Background: We compared the midterm outcome after aortic valve replacement with the Freestyle stentless bioprosthesis for the full-root or subcoronary implantation technique, while adjusting for patient and disease characteristics by a propensity score. Methods: Between 1996 and 2005, 1,014 patients...
| Main Authors: | , , , , , |
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| Format: | Journal Article |
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2008
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| Online Access: | http://hdl.handle.net/20.500.11937/16957 |
| _version_ | 1848749325643939840 |
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| author | Ennker, J. Albert, A. Rosendahl, U. Ennker, I. Dalladaku, F. Florath, Ines |
| author_facet | Ennker, J. Albert, A. Rosendahl, U. Ennker, I. Dalladaku, F. Florath, Ines |
| author_sort | Ennker, J. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Background: We compared the midterm outcome after aortic valve replacement with the Freestyle stentless bioprosthesis for the full-root or subcoronary implantation technique, while adjusting for patient and disease characteristics by a propensity score. Methods: Between 1996 and 2005, 1,014 patients underwent aortic valve replacement with the stentless Medtronic Freestyle bioprosthesis, 168 using full-root technique. Based on a saturated propensity score, 148 matched pairs were created. Mean age of the 296 patients was 73 ± 3 years. Mean follow-up time was 32 ± 30 months (maximum, 116 months). Results: Operative mortality was 4.7% and 2.7% (p = 0.36) in the full-root and subcoronary groups, respectively. Freedom from reoperation, prosthetic valve endocarditis, major bleeding, and thromboembolism after 9 years was 98% ± 1% and 90% ± 7% (p = 0.38), 95% ± 3% and 92% ± 7% (p = 0.76), 72% ± 21% and 98% ± 2% (p = 0.12), and 75% ± 8% and 84% ± 7% (p = 0.28), for full-root and subcoronary groups, respectively. Survival rates after 9 years were 34% ± 24% and 33% ± 11% (p = 0.46), for the full-root and subcoronary groups, respectively. Patients in the full-root group received larger valve sizes (p = 0.03), and the mean transprosthetic gradients at discharge were significantly lower for each valve size. Nevertheless, during follow-up, peak gradients decreased to a greater extent in patients presenting high peak gradients (>36 mm Hg) at discharge. Conclusions: As risk-adjusted comparison of both implantation techniques did not reveal any differences regarding operative and midterm outcomes, full-root replacement can be liberally performed in patients with small aortic roots, annuloaortic ectasia, or requiring replacement of ascending aorta. © 2008 The Society of Thoracic Surgeons. |
| first_indexed | 2025-11-14T07:19:09Z |
| format | Journal Article |
| id | curtin-20.500.11937-16957 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T07:19:09Z |
| publishDate | 2008 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-169572017-09-13T13:36:44Z Ten-Year Experience With Stentless Aortic Valves: Full-Root Versus Subcoronary Implantation Ennker, J. Albert, A. Rosendahl, U. Ennker, I. Dalladaku, F. Florath, Ines Background: We compared the midterm outcome after aortic valve replacement with the Freestyle stentless bioprosthesis for the full-root or subcoronary implantation technique, while adjusting for patient and disease characteristics by a propensity score. Methods: Between 1996 and 2005, 1,014 patients underwent aortic valve replacement with the stentless Medtronic Freestyle bioprosthesis, 168 using full-root technique. Based on a saturated propensity score, 148 matched pairs were created. Mean age of the 296 patients was 73 ± 3 years. Mean follow-up time was 32 ± 30 months (maximum, 116 months). Results: Operative mortality was 4.7% and 2.7% (p = 0.36) in the full-root and subcoronary groups, respectively. Freedom from reoperation, prosthetic valve endocarditis, major bleeding, and thromboembolism after 9 years was 98% ± 1% and 90% ± 7% (p = 0.38), 95% ± 3% and 92% ± 7% (p = 0.76), 72% ± 21% and 98% ± 2% (p = 0.12), and 75% ± 8% and 84% ± 7% (p = 0.28), for full-root and subcoronary groups, respectively. Survival rates after 9 years were 34% ± 24% and 33% ± 11% (p = 0.46), for the full-root and subcoronary groups, respectively. Patients in the full-root group received larger valve sizes (p = 0.03), and the mean transprosthetic gradients at discharge were significantly lower for each valve size. Nevertheless, during follow-up, peak gradients decreased to a greater extent in patients presenting high peak gradients (>36 mm Hg) at discharge. Conclusions: As risk-adjusted comparison of both implantation techniques did not reveal any differences regarding operative and midterm outcomes, full-root replacement can be liberally performed in patients with small aortic roots, annuloaortic ectasia, or requiring replacement of ascending aorta. © 2008 The Society of Thoracic Surgeons. 2008 Journal Article http://hdl.handle.net/20.500.11937/16957 10.1016/j.athoracsur.2007.10.015 restricted |
| spellingShingle | Ennker, J. Albert, A. Rosendahl, U. Ennker, I. Dalladaku, F. Florath, Ines Ten-Year Experience With Stentless Aortic Valves: Full-Root Versus Subcoronary Implantation |
| title | Ten-Year Experience With Stentless Aortic Valves: Full-Root Versus Subcoronary Implantation |
| title_full | Ten-Year Experience With Stentless Aortic Valves: Full-Root Versus Subcoronary Implantation |
| title_fullStr | Ten-Year Experience With Stentless Aortic Valves: Full-Root Versus Subcoronary Implantation |
| title_full_unstemmed | Ten-Year Experience With Stentless Aortic Valves: Full-Root Versus Subcoronary Implantation |
| title_short | Ten-Year Experience With Stentless Aortic Valves: Full-Root Versus Subcoronary Implantation |
| title_sort | ten-year experience with stentless aortic valves: full-root versus subcoronary implantation |
| url | http://hdl.handle.net/20.500.11937/16957 |