Background:
To study the preoperative and intraoperative variables influencing the mean post-operative
transvalvular gradient across stentless porcine valves.
Methods:
From 1995 to 2002, 84 patients underwent stentless valve insertion. The mean age was
73 years, and 63% were male. The valve pathology was aortic stenosis (AS) in 79%,
aortic regurgitation (AR) in 12%, and mixed in 9%. Valve sizes ranged from 21 to 29
with size 27 being most frequent. 54% of patients had concomitant procedures. Patients
had at least yearly clinical and echocardiographic follow-up.
Results:
There was no operative mortality. 9.5% of the patients had significant postoperative
complications. The average echo interval was 18.6 months (range 1–88). The overall
mean transvalvular gradient was 9.88 ± 5.67 (SD) mmHg. Variables associated with significantly reduced gradients were: larger
valve sizes (p = 0.002), younger age (p = 0.05), pre-op AR (p = 0.008), and increasing post-operative interval (p = 0.05). The mean gradients decreased by 0.28 mmHg for each post-operative year. The method of implantation did not significantly
affect gradients (p = 0.26).
Conclusions:
Excellent mean transvalvular gradients were achieved with stentless valves studied,
with a low operative risk. The gradients did not appear to be related to intra-operative
factors, suggesting that insertion techniques can be tailored to suit patient conditions
and surgeon preferences.
Keywords
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© 2005 Australasian Society of Cardiac and Thoracic Surgeons and the Cardiac Society of Australia and New Zealand. Published by Elsevier Inc. All rights reserved.
