Aortic valve replacement: Is the stentless xenograft an alternative to thehomograft? Midterm results

Background. This study was performed to assess the midterm clinical results after aortic valve replacement (AVR) with stentless xenograft (SX) compare d with cryopresen ed aortic or pulmonary homografts (HX). Methods. In 139 patients (< 60 years) undergoing elective AVR, 59 HX and 80 SX were inserted. All patients were followed clinically and by color now D oppler echocardiography for 45 +/- 12 months (range 31-58 months). Results. There were 5 in-hospital deaths (3.5%): 4 HX and 1 SX (p = NS). Th e mean gradient was 6 +/- 2 mm Hg in HX versus 13 +/- 6 mm Hg in SX (p < 0. 001) remained unchanged during follow-up. Actuarial survival (HX 77%, SX 80 %), freedom from endocarditis (HX 91%, SX 99%), freedom from thromboembolic events (HX 98%, SX 90%), and freedom from reoperation (HX 98%, SX 100%) we re comparable between groups after 58 months. Conclusions. Despite slightly higher transvalvular gradients, the stentless aortic valve achieved excellent midterm results, when compared with homogr afts. (Ann Thorac Surg 1999;68:919-24) (C) 1999 by The Society of Thoracic Surgeons.