Key result
Stentless biological prostheses show no 5-year survival or quality of life benefit over stented valves.
Why the study?
Quality of life in elderly patients undergoing aortic valve replacement with stented versus stentless biological prostheses had not been fully assessed.
Does aortic valve replacement with stentless biological prostheses improve quality of life compared to stented xenopericardial prostheses in elderly patients with severe aortic stenosis?
RCT (n=114)
1:1
No
Does aortic valve replacement with stentless biological prostheses improve quality of life compared to stented xenopericardial prostheses in elderly patients with severe aortic stenosis?
Absolute Event Rate: 90% vs 96%
p-value: p=0.226
Both stented and stentless biological prostheses significantly improve quality of life in elderly patients with severe aortic stenosis, with no significant difference between the two types.
Aim. The paper aims to assess the quality of life of patients subjected to aortic valve replacement with a stented/stentless biological prosthesis. Methods. The research was done at the Acquired Heart Disease Department of Meshalkin National Medical Research Center. The inclusion criteria were patient age older than 65 years and severe stenosis of the aortic valve. 114 patients were randomized 1:1 in two groups: group I patients received stentless biological prostheses, while group II patients — stented xenopericardial ones. All patients underwent aortic valve replacement under normothermic cardiopulmonary bypass. Mean follow-up was 3.9 [2.77; 4.55] years, mean age 71.5±4 (65–84) years, mean left ventricle ejection fraction 65.5 (40–86) % and mean preoperative Log.Euroscore 5.4±1.3 (1.4–12.4). The quality of life was assessed by using a standard questionnaire SF-36.Results. Peak transprosthetic gradients at 1-year follow-up amounted to 16.22±4.34 and 24.66±4.74 mm Hg for group I and group II respectively. The 5-year survival rate was 90 [81; 99] % and 96 [90; 100] % for the two groups respectively and did not differ statistically (log rank test, p = 0.226). A statistically significant improvement of quality of life among patients in both groups was observed at 1-year follow-up, as compared to the preoperative values, however, marked intergroup differences in any of the parameters were not recorded.Conclusion. The quality of life after aortic valve replacement with stented and stentless biological prostheses in elderly patients confirms clinical and functional efficiency of both methods, does not show sound advantages of any of them and improves both the physical component of health and subjective emotional level.Received 25 July 2017. Revised 18 August 2017. Accepted 28 August 2017.Funding: The study was carried out with the support of a grant of the President of the Russian Federation (МД–6967.2016.7) created to provide government assistance to the leading research centers in Russian Federation.Conflict of interest: The authors declare no conflict of interest.
No takes yet. Share an insight, caveat, or question.
Демидов et al. (2017) conducted an RCT in Severe stenosis of the aortic valve (n=114). Stentless biological prostheses vs. Stented xenopericardial biological prostheses was evaluated on 5-year survival rate (p=0.226). Aortic valve replacement with stentless biological prostheses resulted in similar 5-year survival (90% vs 96%, p=0.226) and quality of life improvements compared to stented prostheses.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: