Stentless Bioprosthesis in Surgical Treatment of Aortic Root: Mid-term Results

Stentless bioprostheses with superior hemodynamics, laminar flow patterns, lack of need for anticoagulation and perhaps improved durability offer several advantages over traditional valves. The main purpose of this study was to determine early and mid-term results in surgical treatment of the aortic valve disease in elderly patients using stentless bioprosthesis. Between September 1997 and April 2000, 10 patients (8 males 2 females; mean age 63±12.7 years; range 33-74 years) received stentless bioprosthesis. Total root replacement was performed in nine patients and subcoronary implantation technique was done in one. The mean follow-up duration was 14.8±9.4 months (range, 2 to 31 months). There was one (10%) early mortality due to low cardiac output. Late mortality was not observed. Actuarial survival was 90 ± 9.5 % at two years. We did not observe any valve-related morbidity. One patient was required permanent pacemaker due to complete heart block after the operation. Decreasing of the mean transbioprosthesis gradient and increasing of the effective orifice area were demonstrated. Stentless biophrosthesis can be used safely for the replacement of aortic valve pathology, espcially in elderly patients because of optimal durability with almost not thromboembolic events and no requirement of anticoagulation.