Aortic valve replacement with stentless porcine aortic bioprosthesis

David, Tirone E.; Pollick, Charles; Bos, Joanne

doi:10.1016/s0022-5223(19)35640-5

Cited by 159 publications

(50 citation statements)

References 20 publications

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“…Several hypotheses were formulated to explain the changes in hemodynamics in general and in coronary circulation in particular. Recently (3), it was demonstrated that in b-blocked pigs that changes in coronary circulation do not depend on mechanical obstructions to the coronary flow but rather on changes in preloads, as confirmed by the restoration of the hemodynamic situation after the Trendelenburg maneuver (3,4). In the case of b-blocked animals, it was observed that the vertical lifting of the heart reduces cardiac output, coronary flow, and aortic pressure, while right and left ventricular end-diastolic pressures (RVEDP, LVEDP) are increased.…”

Section: Discussionmentioning

confidence: 94%

“…In the 1980s, a so-called "stentless" bioprosthesis arose in order to decrease the hemodynamic disadvantages of stented prostheses, eliminating the use of a sustentation ring to assemble the prostheses (4,5). Some problems related to implantation are reported in the literature with considerable rates of reoperation due to aortic insufficiency in midterm follow-up (6)(7)(8)(9)(10).…”

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confidence: 99%

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“Less Stented” Bovine Pericardial Xenograft: A New Concept

et al. 2006

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The in vitro hemodynamic behavior of a bovine pericardium xenograft with discontinuity of the annular support, named the "Less Stented" bovine pericardial xenograft, was analyzed. A "Less Stented" bovine pericardial xenograft consisting of a glutaraldehyde-treated bovine pericardium prosthesis manufactured in Braile Biomédica Ltd, São José do Rio Preto, São Paulo, Brazil, was used according to the same protocols of the stented bioprosthesis manufacturer. Bovine pericardial xenografts were tested in a pulse simulator and analyzed in a cardiac simulator, with respect to the transvalvular gradient, regurgitant fraction and leakage volume, discharge coefficient, performance, and efficiency index. Analyses were performed by Pearson's correlation test and simple linear regression. The transvalvular gradients ranged between 6.37 and 11.62 mm Hg with a mean flow between 4.39 and 7.96 L/min, giving a good correlation (0.8291) on the regression curve with an increase in flow. The regurgitant fraction ranged between 10.95 and 17.94% and leakage volume between 4.49 and 7.87%. The discharge coefficient, performance, and efficiency index showed favorable behavior with the flow increase, with good correlation coefficient (0.9385, 0.9332, and 0.9024, respectively). The initial results of the "Less Stented" bovine pericardial xenograft size 25 analyses demonstrated a satisfactory in vitro performance. Evaluations of the hemodynamic performance of small size "Less Stented" bovine pericardial xenograft should be made to clarify the biological behavior of this new xenograft.

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Section: Discussionmentioning

confidence: 94%

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confidence: 99%

“Less Stented” Bovine Pericardial Xenograft: A New Concept

et al. 2006

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“…Stentless aortic valves have been reintroduced in clinical practice for nearly two decades. 1 After a phase of generalized enthusiasm, their role in treatment of irreparable aortic valve disease is currently be-ing reconsidered. 2,3 Undoubtedly, the expectation of longer durability compared to stented xenografts has been disappointing.…”

Section: Discussionmentioning

confidence: 99%

Seven-Year Performance of the Edwards Prima Plus Stentless Valve with the Intact Non-Coronary Sinus Technique

et al. 2008

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“…ARR is traditionally associated with increased mortality, coronary ischemic complications, and transfusions, and with longer crossclamp and cardiopulmonary bypass times. 5 Although many highvolume surgical groups, 6,7 such as that of Bianco and colleagues, 1 have achieved outcomes with ARR similar to those with SAVR, this may not be for those who rarely perform ARR. Although some advantages of comparable durability have been seen between older stented bioprosthetic valves and stentless porcine valves, newer generation stented valves are purported to outlast the previously expected 10-to 15-year valve life.…”

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confidence: 99%