[Is a bioprosthesis with a rigid stent a good choice for aortic valve replacement in elderly patients?].

BACKGROUND: Either stented or stentless bioprostheses can be used for aortic valve replacement (AVR) in aged patients. However the choice of the valve type remains controversial. The implantation technique of the stentless valves is more complex but the haemodynamic performance supposed to be superficial to the stented ones. The aim of the study was to review our experience with stented bioprostheses implanted in the last year.

MATERIAL AND METHODS: The study reviews retrospectively 35 patients who underwent AVR with Biocor fy St Jude Medical from May 2000 to May 2001. The mean age was 73 years (65-81). Associated procedures were CABG in 17, aortoplasty in 3 and Bentall procedure in 1. Thirty-two patients had aortic stenosis, the mean preoperative gradient was 44.2 mmHg. Nineteen implanted valves were 23 mm and smaller in diameter. All patients were examined by a cardiologist (including ECHO) one month after surgery.

RESULTS: There was no early mortality (30 days) and no sign of structural valve deterioration or valve thrombosis. Mean hospital stay was 10.2 days (5-30). Mean postoperative gradient one month after surgery was 14.1 mmHg (6-24).

CONCLUSIONS: The AVR with a stented bioprosthesis is a standard procedure with excellent results, the postoperative gradient is comparable to the gradient of the stentless valves.