Medium to long-term clinical outcome following stentless aortic valve replacement: comparison between allograft and xenograft valves

Abstract

The xenograft stentless valve was designed to emulate the haemodynamic performance of the allograft. Early outcomes using either surgical option (stentless xenograft valve or allograft) have been similar. However, follow-up outcomes remain to be compared. Between 1st January 1991 and 1st January 2001, 415 patients underwent aortic valve replacement. Two hundred and seventeen patients received an allograft and in 198 patients a Toronto stentless porcine valve (TSPV) was implanted. Mean time to follow-up was 6.3+/-4.4 years. Ten years freedom from structural valve deterioration (SVD) (TSPV 86+/-5%, allograft 82+/-5%, P=0.49) and freedom from reoperation (RE) (TSPV 80+/-4% vs. allograft 85+/-4%, P=0.61) were not significantly different. The TSPV was associated with significantly worse actuarial survival than the homograft (TSPV 40+/-4% vs. homograft 55+/-4%, P=0.02). However, after adjustment for other variables using a multivariate model, TSPV use was not an independent predictor of impaired late survival (LS) (P=0.44). Kaplan-Meier analysis in a subgroup of patients aged 45-65 years comparing LS, RE and SVD between xenografts and allografts identified similar results. The porcine stentless valve may be associated with similar clinical performance to the allograft over the medium to long-term.

The Prevalence of Coronary Artery Disease in Bicuspid Aortic Valve Patients: An Overview of the Literature

“…Thirty-five studies 7,12,13,[17][18][19][20][21][22][23][24][25][26]28,29,[31][32][33][34]36,39,40,[45][46][47][48][49][50][51]53,[55][56][57][58][59]…”

“…Twenty-five studies 7 12 13 18 20 23 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 reported on the prevalence of a concomitant CABG, which included a total of 16,095 patients. A concomitant CABG was performed in a total of 5,581 (34.7%) patients.…”

“…Thirty-five studies 7 12 13 17 18 19 20 21 22 23 24 25 26 28 29 32 33 34 36 39 40 45 46 47 48 49 50 51 52 53 54 55 56 57 58 reported on the prevalence of hypertension, which included 52,807 patients. Hypertension was present in a total of 34,892 (66.1%) patients.…”

Surgery for Young Adults With Aortic Valve Disease not Amenable to Repair

“…In young adults it appears that stentless valves may have similar clinical performance to homografts during follow up ( 62 , 63 ). The differences between stented and stentless valves are less clear.…”

Culture of Pig Induced Pluripotent Stem Cells without Direct Feeder Contact in Serum Free Media

“…The pig is an important species as a food source in animal agriculture and as a large animal disease and injury model in the biomedical arena [1][2][3][4]. To further the agricultural and biomedical utility of pigs, great efforts have been made to genetically manipulate these animals through the development of technologies such as somatic cell nuclear transfer (SCNT) [2,5,6].…”