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Risk in Elderly Patients After Stentless Versus Stented Aortic Valve Surgery

Heart Institute Lahr/Baden, Lahr, Germany

For reprint information contact: Jürgen Ennker, MD Tel: 49 7821 92 5101 Fax: 49 7821 925110 email: ennker{at}heart-lahr.com Heart Institute Lahr/Baden, Lahr D-77933, Germany.

Recent studies suggest that the hemodynamic advantage of stentless bioprostheses over the stented type improves long-term survival after aortic valve replacement, but the more complex and time-consuming implantation technique may increase the risks of operative death and postoperative complications. Between April 1996 and June 2001, 519 patients with a mean age of 76 ± 5 years underwent aortic valve replacement using a stentless (Medtronic Freestyle, n = 277) or stented bioprosthesis (Medtronic Mosaic, n = 242). Multiple logistic regression analysis considering different patient populations revealed no increased risk of operative death, postoperative complications, or neurological impairment after implantation of a stentless bioprosthesis. Survival curves in respect of 367 patients who underwent aortic valve replacement up to September 2000 and were followed up for 3 years were not different (p = 0.98). As the patients were elderly, improved survival due to implantation of a stentless valve could not be demonstrated within this time span.

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