Regresión de la masa ventricular izquierda en la sustitución valvular aórtica con prótesis biológicas en anillos aórticos pequeños. ¿Válvulas soportadas o no soportadas?

Abstract

Introduction and objectivesThe use of Stentless bioprosthesis is associated with lower transvalvular gradients and rapid regression in left ventricular mass (LVM). Recent studies suggest that there are no differences regardingt Stented bioprosthesis. There is no comparison in populations with small aortic annulus prevalence. We analysed survival, functional class status and left ventricular mass regression index (LVMRI) in patients with an aortic annulus equal or smaller than 21mm. MethodsRetrospective analytical study of 72 patients matched with propensity score who underwent scheduled isolated aortic valve replacement due to severe aortic stenosis from March 2003 to February 2010 with small aortic annulus 19-21mm (24 Stentless Freedom versus 48 Stented Mitroflow, Sorin Group). ResultsMean follow-up was 51.4±22 months. No significant differences were detected in functional class, survival nor mean LVMRI (44±22g/m2 in Stented, 39,4±19g/m2 in Stentless (p=0.86). ConclusionsIn small aortic annulus patients (19-21mm), no statistical significant differences were found between bioprosthesis.