Performance of Edwards prima stentless aortic valve over eight years.
Jin XY., Ratnatunga C., Pillai R.
Long-term clinical and hemodynamic performance is a key consideration in using a stentless aortic bioprosthesis. This study reports clinical and hemodynamic performance of Prima stentless aortic valve during our 8-year follow-up. In the study, 85 patients underwent aortic valve replacement (Edwards Prima or Prima plus stentless valve) and had follow-up at discharge and then annually up to 8 years. The mean age at operation was 72 +/- 5 yrs, 49 were male and 25% underwent concomitant CABG. Doppler Echo studies were performed to determine mean pressure gradient (mPG), effective orifice area (EOA) and the degree of regurgitation of stentless valves. Aortic root geometry was assessed by the ratio of sinotubular junction to valve size at peak systole. Patient survival rate was 82% +/- 5% at 5th year and 72% +/- 6% at 8th year. The freedom from valve structure failure was 97% +/- 2% at 5th and 8th year. Valve mPG and EOA at 8 years remained significantly better than those at discharge (6.8 +/- 4.4 mm Hg v 9.7 +/- 6.2 mm Hg; 1.91 +/- 0.54 cm(2) v 1.63 +/- 0.71 cm(2), both P <.01), and did not differ from those at 3-year follow-up. Mean sinotubular junction diameter remained below valve size (0.96 +/- 0.14). Mild degree of valvular regurgitation was present in 17% of patients, but this did not progress over the period of follow-up. After aortic valve replacement with the Prima stentless valves, excellent valve hemodynamics and normal root geometry were well maintained up to 8 years, but longer-term follow-up of a larger cohort remains essential.