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This Article Extract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Alexander John Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by John, A. Search for Related Content PubMed PubMed Citation Articles by John, A. Related Collections Valve disease

Risk in Elderly Patients After Stentless versus Stented Aortic Valve Surgery

Cardiac Surgeon, Heart Centre Osnabrueck, 49214 Bad Rothenfelde, Germany

It was interesting to read the article, "Risk in elderly patients after stentless versus stented aortic valve surgery" written by Enker and colleagues.¹ The stent-related problems of higher gradients, turbulent flow and susceptibility to infective endocarditis, paravalvular leaks and reoperations have not been dealt with in this article. The stentless valves are resistant to infections and, in our experience, ideal substitutes for patients with native or prosthetic valve endocarditis. That stentless valves are hemodynamically superior to stented valves has already been convincingly demonstrated.^2,3 About the complexity of the technique of implantation, I must say, that when the root is small, especially in older people, implanting any valve, stentless or stented, is difficult. With sufficient experience, and a standardised technique, implanting a stentless valve can no longer be that complex and difficult. We have brought down the aortic crossclamp time to about 60 minutes and our centre has an experience of implanting over 600 Medtronic Freestyle valves. The advantage is being able to put in a comparatively larger valve resulting in a rapid and better postoperative recovery and possibly improved survival.⁴

REFERENCES

1. Ennker J, Rosendahl U, Ennker IC, Bauer S, Florath I. Risk in elderly patients after stentless versus stented aortic valve surgery. Asian Cardiovasc Thorac Ann . 2003;11:37–41.[Abstract/Free Full Text]

2. Jin XY, Gibson DG, Yacoub MH, Pepper JR. Perioperative assessment of aortic homograft, Toronto stentless valve, and stented valve in the aortic position. Ann Thorac Surg . 1995;60:S395–401.

3. Silberman S, Shaheen J, Merin O, Fink D, Shapira N, Liviatan-Strauss N, Bitran D. Exercise hemodynamics of aortic prostheses: comparison between stentless bioprostheses and mechanical valves. Ann Thorac Surg . 2001;72:1217–21.[Abstract/Free Full Text]

4. Westaby S, Horton M, Jin XY, Katsumata T, Ahmed O, Saito S, Li HH, Grunkemeier GL. Survival advantage of stentless aortic bioprostheses. Ann Thorac Surg . 2000;70:785–90.[Abstract/Free Full Text]

This Article Extract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Alexander John Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by John, A. Search for Related Content PubMed PubMed Citation Articles by John, A. Related Collections Valve disease