Objective: In 1999 stentless heart valves were introduced for treatment of the aortic valve disease in elderly patients at the Department of Cardiac Surgery of the University of Debrecen.
Patients, methods: Between December 1999 and November 2001 63 patients underwent aortic valve replacement with Sorin Pericarbon stentless valve. The mean gradient was 80 +/- 11 mmHg, the left ventricular wall thickness was 15.5 +/- 0.7 mm and the ejection fraction was 54 +/- 8% preoperatively. 4 patients were in NYHA II, 47 in NYHA III and 12 in NYHA IV functional class. 42 patients had isolated aortic valve replacement, the remaining 21 patients underwent combined surgical procedure. The aortic x-clamp and perfusion times were 125 +/- 27 and 153 +/- 48 minutes respectively. Nine 21 mm, twenty-three 23 mm, seventeen 25 mm, twelve 27 mm and two 29 mm valves were implanted.
Results: The hospital mortality was 6% (four patients). Transient atrial fibrillation was the most frequent postoperative complication. 77% of the patients had uneventful recovery and left hospital one week after surgery. Transthoracic echocardiography was performed at all patients before discharge and in December 2001. The mean follow up time was 9.7 +/- 5.8 months. 86% of the patients were in NYHA I functional class at the time of the follow up. The mean and peak transvalvular gradients were 9.4 +/- 4.1 mmHg and 16.1 +/- 6.8 mmHg respectively. The left ventricular wall thickness has decreased significantly (12.5 +/- 1.1 mm).
Conclusion: The Sorin Pericarbon stentless valve is an easily implantable valve replacement device. Due to the excellent hemodynamic properties and the unnecessary anticoagulation it could be safely used in elderly patients.