Stentless vs. Stented Aortic Valve Replacement: Left Ventricular Mass Regression

The aim of this retrospective study was to evaluate the time-related regression of left ventricular hypertrophy after stentless vs. stented aortic valve replacement. From January 1992 to December 2002, 145 patients had a Toronto stentless porcine valve and 106 had a stented Carpentier-Edwards aortic valve replacement. Over a 10-year follow-up, survival was superior in the Toronto group vs. the Carpentier-Edwards group (84% vs. 74% at 4 years; 78% vs. 68% at 6 years; p < 0.001). A significant and constant reduction of peak and mean transvalvular gradients after valve replacement resulted in substantial regression of left ventricular mass index in both groups, which did not reach statistical significance. However, this phenomenon stopped at 3 years, and left ventricular mass index increased slowly after 5 years. Stentless and stented bioprostheses both showed good early and late clinical and hemodynamic outcomes, with the advantage of better midterm survival for stentless xenografts.