OBJECTIVES: This study assesses the hemodynamic performance of various aortic valve substitutes, the subsequent regression of left ventricular hypertrophy and the clinical outcomes after aortic valve replacement, in different age groups
METHODS: A total of 120 patients with isolated aortic valve stenosis were included in this prospective randomized trial. In group I (age 75 years), patients received a stentless bioprosthesis (CE Prima Plus n=20) or a stented bioprosthesis (CE Perimount n=20).
RESULTS: At 12 months, in group I, pulmonary autografts had significantly lower mean gradients when compared to mechanical valves ( 2.6 vs 10.9 mmHg, p=0.0005). Left ventricular mass regression however, was comparable in both groups (114±27.2 vs 110±30.2 g/m²). In group II, mean gradients were lower for stentless bioprostheses compared to mechanical valves (7.0 vs 8.9 mmHg, p=0.81), however it did not reach statistical significance. The rate of left ventricular mass regression was comparable(109±29.3 vs 111±27.6 g/m²). In group III, mean gradients did not differ significantly (7.8 vs 6.5 mmHg, p=0.06).Regression of left ventricular mass was comparable in both groups (104±28.5 vs 106±32.5 g/m²).
CONCLUSIONS: The rate and completeness of left ventricular mass regression was uniform for all prostheses and was not influenced by the differences in transvalvular gradients.
Author(s): Mirko Doss, Heinz Deschka, Petar Risteski, Gerhard Wimmer Greinecker, Anton Moritz
