Are stentless valves hemodynamically superior to stented valves? Long-term follow-up of a randomized trial comparing Carpentier–Edwards pericardial valve with the Toronto Stentless Porcine Valve

Cohen, Gideon; Zagorski, Brandon; Christakis, George T.; Joyner, Campbell; Vincent, Jessica; Sever, Jeri; Harbi, Sumaya; Feder-Elituv, Randi; Moussa, Fuad; Goldman, Bernard S.; Fremes, Stephen E.

doi:10.1016/j.jtcvs.2009.04.067

Cited by 45 publications

(31 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Other potential management options of the small aortic annulus during AVR include the implantation of smallersized mechanical valves (22,23) or stentless bioprostheses (24,25). However, bleeding risks may be 20 times higher among elderly patients with mechanical compared with biological valves (26), generally limiting the use of mechanical valves to younger patients (27,28).…”

Section: Discussionmentioning

confidence: 99%

“…However, bleeding risks may be 20 times higher among elderly patients with mechanical compared with biological valves (26), generally limiting the use of mechanical valves to younger patients (27,28). Furthermore, the hemodynamic superiority of stentless aortic bioprostheses continues to be debated, with available studies reporting conflicting data, both for normal (24,25,29) and smallsized aortic annuli (30 -32). Our center published its (32).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Transcatheter Aortic Valve Implantation in Patients With Severe Aortic Stenosis and Small Aortic Annulus

Kalavrouziotis

Rodés‐Cabau

Bagur

et al. 2011

Journal of the American College of Cardiology

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Transcatheter Aortic Valve Implantation in Patients With Severe Aortic Stenosis and Small Aortic Annulus

Kalavrouziotis

Rodés‐Cabau

Bagur

et al. 2011

Journal of the American College of Cardiology

View full text Add to dashboard Cite

show abstract

“…In a prospective randomized trial, 12-year freedom from reoperation was 92Ϯ5% with the Carpentier-Edwards pericardial valve, compared with 75Ϯ5% with the Toronto SPV valve (Pϭ0.7). 23 To minimize the potential for bias, the analyses of longevity of bioprosthetic aortic valves in the present study were restricted to stented bioprostheses. One of those, the Ionescu-Shiley bioprosthetic valve, had been previously shown to undergo early failure, with 10-year freedom from reoperation of 57Ϯ4% and 61Ϯ6% following AVR and MVR, respectively.…”

Section: Discussionmentioning

confidence: 99%

Reoperation of Left Heart Valve Bioprostheses According to Age at Implantation

et al. 2011

View full text Add to dashboard Cite

Background-Evidence supporting the use of bioprostheses for heart valve replacement in young adults is accumulating.However, reoperation data, which may help guide clinical decision making in young patients, remains poorly defined in the literature. Methods and Results-We examined the need for reoperation in 3975 patients who underwent first-time bioprosthetic aortic valve replacement (AVR) (nϭ3152) or mitral valve replacement (MVR) (nϭ823). There were 895 patients below the age of 60 years at bioprosthesis implant (AVR, nϭ636; MVR, nϭ259

show abstract

“…44,45 In general, differences in LVMR between stented and stentless valves persisted until 1 year postsurgery, but not longer. [43][44][45][46][47] Therefore, these results indicate that LVMR may occur faster in stentless valves during the first year postsurgery. 47 50 with near absence (#1%) of PPM.…”

Section: Mass Regressionmentioning

confidence: 95%

The Freedom SOLO bovine pericardial stentless valve

Stanger¹,

Tevaearai²,

Carrel³

2014

RRCC

View full text Add to dashboard Cite

Abstract:The third-generation bovine pericardium Freedom SOLO (FS) stentless valve emerged in 2004 as a modified version of the Pericarbon Freedom stentless valve and as a very attractive alternative to stented bioprostheses. The design, choice of tissue, and anticalcification treatment fulfill most, if not all, requirements for an ideal valve substitute. The FS combines the singlesuture, subcoronary implantation technique with the latest-generation bovine pericardial tissue and novel anticalcification treatment. The design allows imitation of the native healthy valve through unrestricted adaption to the patient's anatomy, reproducing a normal valve/root complex. However, despite hemodynamic performance superior to stented valves, we are approaching a critical observation period as superior durability, freedom from structural valve deterioration, and nonstructural failure has not been proven as expected. However, optimal performance and freedom from structural valve deterioration depend on correct sizing and perfect symmetric implantation, to ensure low leaflet stress. Any malpositioning can lead to tissue fatigue over time. Furthermore, the potential for better outcomes depends on optimal patient selection and observance of the limitations for the use of stentless valves, particularly for the FS. Clearly, stentless valve implantation techniques are less reproducible and standardized, and require surgeondependent experience and skill. Regardless of whether or not stentless valve durability surpasses third-generation stented bioprostheses, they will continue to play a role in the surgical repertoire. This review intends to help practitioners avoid pitfalls, observe limitations, and improve patient selection for optimal long-term outcome with the attractive FS stentless valve.

show abstract

Are stentless valves hemodynamically superior to stented valves? Long-term follow-up of a randomized trial comparing Carpentier–Edwards pericardial valve with the Toronto Stentless Porcine Valve

Abstract: Although offering improved hemodynamic outcomes, the SPV did not afford superior mass regression or improved clinical outcomes up to 12 years after implantation.

Cited by 45 publications

References 46 publications

Transcatheter Aortic Valve Implantation in Patients With Severe Aortic Stenosis and Small Aortic Annulus

Transcatheter Aortic Valve Implantation in Patients With Severe Aortic Stenosis and Small Aortic Annulus

Reoperation of Left Heart Valve Bioprostheses According to Age at Implantation

The Freedom SOLO bovine pericardial stentless valve

Contact Info

Product

Resources

About