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Báo cáo y học: "Comparative evaluation of left ventricular mass regression after aortic valve replacement: a prospective randomized analysis"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Comparative evaluation of left ventricular mass regression after aortic valve replacement: a prospective randomized analysis. | Doss et al. Journal of Cardiothoracic Surgery 2011 6 136 http www.cardiothoracicsurgery.Org content 6 1 136 JCTS JOURNAL OF CARDIOTHORACIC SURGERY RESEARCH ARTICLE Open Access Comparative evaluation of left ventricular mass regression after aortic valve replacement a prospective randomized analysis Mirko Doss Jeffrey P Wood Arndt H Kiessling and Anton Moritz Abstract Background We assessed the hemodynamic performance of various prostheses and the clinical outcomes after aortic valve replacement in different age groups. Methods One-hundred-and-twenty patients with isolated aortic valve stenosis were included in this prospective randomized randomised trial and allocated in three age-groups to receive either pulmonary autograft PA n 20 or mechanical prosthesis MP Edwards Mira n 20 in group 1 age 55 years either stentless bioprosthesis CE Prima Plus n 20 or MP Edwards Mira n 20 in group 2 age 55-75 years and either stentless CE Prima Plus n 20 or stented bioprosthesis CE Perimount n 20 in group 3 age 75 . Clinical outcomes and hemodynamic performance were evaluated at discharge six months and one year. Results In group 1 patients with PA had significantly lower mean gradients than the MP 2.6 vs. 10.9 mmHg p 0.0005 with comparable left ventricular mass regression LVMR . Morbidity included 1 stroke in the PA population and 1 gastrointestinal bleeding in the MP subgroup. In group 2 mean gradients did not differ significantly between both populations 7.0 vs. 8.9 mmHg p 0.81 . The rate of LVMR and EF were comparable at 12 months each group with one mortality. Morbidity included 1 stroke and 1 gastrointestinal bleeding in the stentless and 3 bleeding complications in the MP group. In group 3 mean gradients did not differ significantly 7.8 vs 6.5 mmHg p 0.06 . Postoperative EF and LVMR were comparable. There were 3 deaths in the stented group and no mortality in the stentless group. Morbidity included 1 endocarditis and 1 stroke in the stentless compared to 1 endocarditis 1 .