Back to Search
Start Over
Hemodynamic benefits of the Toronto Stentless Valve.
- Source :
-
The Journal of thoracic and cardiovascular surgery [J Thorac Cardiovasc Surg] 1996 Dec; Vol. 112 (6), pp. 1431-45; discussion 1445-6. - Publication Year :
- 1996
-
Abstract
- We report on 254 consecutive patients (170 male, 84 female) undergoing aortic valve replacement with the Toronto SPV Stentless Valve (St. Jude Medical, Inc., St. Paul, Minn.). Mean age (+/- standard deviation) was 62.1 +/- 11.6 years. Three patients (1%) received sizes 21 or 22 mm, 24 (9%) received size 23 mm, and 227 patients (89%) received sizes 25, 27, or 29 mm. Serial echocardiography was used to assess valve performance during a 3-year follow-up. Mean gradient decreased by 35.8% (p < 0.0001; 95% confidence interval -39.6%, -31.7%) from postoperative values to the 3- to 6-month follow-up and by 6.1% (p = 0.004; 95% confidence interval -10.1%, -2%) at each subsequent interval; effective orifice area increased by 17.2% (p = 0.0001; 95% confidence interval 12.0%, 22.6%) initially and by 4.4% (p < 0.001; 95% confidence interval 1.8%, 7.0%) thereafter. At 2 years of follow-up, mean gradient was 3.3 +/- 2.1 mm Hg and mean effective orifice area was 2.2 +/- 0.8 cm2. Studies on left ventricular mass were carried out on 84 patients. Left ventricular mass decreased by 14.3% (37.8 +/- 57.9 gm; p < 0.0001; 95% confidence interval -53.7, -21.9 gm) and left ventricular mass index decreased by 15.2% (21.1 +/- 30.5 gm/m2; p < 0.0001; 95% confidence interval -29.5, -12.7 gm/m2) from postoperative values to the 3- to 6-month follow-up interval. The reduction in residual gradient and potential regression in left ventricular hypertrophy may have a beneficial prognostic implication. We believe that the unique stentless design of the Toronto SPV Stentless Valve allows this to occur.
- Subjects :
- Actuarial Analysis
Aged
Aged, 80 and over
Aortic Valve Insufficiency complications
Aortic Valve Insufficiency diagnostic imaging
Aortic Valve Insufficiency surgery
Disease-Free Survival
Echocardiography
Female
Follow-Up Studies
Humans
Hypertrophy, Left Ventricular diagnostic imaging
Hypertrophy, Left Ventricular etiology
Male
Middle Aged
Prospective Studies
Stents
Treatment Outcome
Aortic Valve Insufficiency physiopathology
Heart Valve Prosthesis methods
Hemodynamics
Hypertrophy, Left Ventricular physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 0022-5223
- Volume :
- 112
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- The Journal of thoracic and cardiovascular surgery
- Publication Type :
- Academic Journal
- Accession number :
- 8975834
- Full Text :
- https://doi.org/10.1016/S0022-5223(96)70001-6