Outcomes and hemodynamics after aortic valve replacement: a comparison of stentless versus mechanical valves.

PURPOSE Some investigators suggest that hemodynamic outcomes may be superior with the stentless aortic bioprosthesis when compared with a mechanical valve. The goal of this study was to characterize outcomes and hemodynamic data associated with each type of valve. SUBJECTS AND METHODS Patient outcomes and echocardiographic data were compared between 25 patients with stentless valves and 59 patients with mechanical valves. RESULTS There were no significant differences in survival and freedom from cardiovascular adverse events between two groups. The duration of anticoagulation therapy was limited to 3 months in the stentless group. There was no significant difference in preoperative and postoperative New York Heart Association (NYHA) status when comparing the two groups, and NYHA status significantly improved in both groups (P<0.05). There was no significant difference in the echocardiographic data when comparing the two groups. CONCLUSION Aortic valve replacement using the stentless valve and the mechanical valve provided good clinical and hemodynamic outcomes. There was no significant difference in these parameters when comparing the two groups. There may be advantages in the limited required duration of anticoagulation therapy of the stentless valve , especially in elderly patients. However, longer follow-up is required before definitive conclusions regarding the benefits of the stentless valve relative to the mechanical valve can be determined.