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• W2017803480 abstract "En la sustitución valvular aórtica se considera que las prótesis no soportadas (PNS) revierten la hipertrofia ventricular izquierda en mayor cuantía que las prótesis soportadas (PS). No existe una comparativa en una población no anglosajona. Pretendemos detectar diferencias significativas analizando la supervivencia, la clase funcional de la New York Heart Association y la regresión del índice de masa ventricular izquierda, entre otros. Estudio analítico retrospectivo, pareado mediante puntuación de propensión, de 120 pacientes intervenidos de forma programada de sustitución valvular aórtica aislada por estenosis aórtica severa desde abril de 2002 a marzo de 2009 con prótesis biológicas de pericardio bovino (60 PNS Freedom, 60 PS Mitroflow, Sorin Group) sobre un total de 138. El seguimiento medio fue de 48,4 ± 22 meses. No se detectaron diferencias en la clase funcional New York Heart Association (media 1,78 ± 0,5 PNS, 1,72 ± 0, 6 PS, p = 0,616) ni en la regresión media del índice de masa ventricular izquierda, que fue de 42,2 g/m2 (25,3%) en PS y de 36,3 g/m2 (22,6%) en PNS (p = 0,467). Las PNS presentaron menores gradientes medios transaórticos (PS 14,4 ± 6,8 mmHg, PNS 9,3 ± 3,2 mmHg, p = 0,05) y mayores índices de áreas de orificio efectivo (PS 0,76 ± 0,1 cm2/m2, PNS 0,83 ± 0,1 cm2/m2, p = 0,04) dentro de los primeros 24 meses, igualándose con posterioridad. Tampoco existieron diferencias en la supervivencia (Mantel-Cox, p = 0,185). Las PS de nueva generación son tan efectivas como las PNS, sin presentar diferencias estadísticamente significativas en supervivencia, clase funcional New York Heart Association ni regresión del índice de masa ventricular izquierda durante el seguimiento, incluso en pacientes con anillo aórtico de 19–21 mm. It is considered that a Stentless bioprosthesis reverses the left ventricular hypertrophy more than a Stented bioprosthesis in aortic valve replacement (AVR). There is no comparison in a non-Anglo-Saxon population. We aim to determine whether there are any statistically significant differences when analysing the survival, New York Heart Association (NYHA) functional status, and regression of left ventricular mass index (LVMI), as well as other variables. A retrospective analytical study was conducted on 120 patients matched by propensity score who, from April 2002 to March 2009, underwent scheduled isolated AVR due to severe aortic stenosis with bovine pericardial tissue valves (60 Stentless Freedom versus 60 Stented Mitroflow, Sorin Group). The mean follow-up was 48.4±22 months. No significant differences were detected in NYHA functional class (mean 1.78±0.5, Stentless Vs 1.72 ± 0.6 Stented, p = .616), or mean LVMI regression, which was 42.2 g/m2 (25.3%) in Stented, and 36.3 g/m2 22.6%) in Stentless (p=.467). Stentless valves had a lower transaortic mean gradient (14.4 ± 6.8 mmHg Stented, Vs 9.3± 3.2 mmHg Stentless, P=.05), and a higher indexed effective orifice area (0.76 ± 0.1 cm2/m2 Stented Vs 0.83 ± 0.1 cm2/m2 Stentless, p=.04) within the first 24 months postoperative, becoming similar later. There was no difference in survival (p=.185). Stented biological valves are as effective as Stentless bioprostheses. There were no statistically significant differences in survival, NYHA functional class, or LVMI regression at the mean follow up, even in patients with a small aortic annulus of 19–21 mm." @default.
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• W2017803480 date "2013-01-01" @default.
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• W2017803480 title "Sustitución valvular aórtica con prótesis biológicas en pacientes con estenosis aórtica severa. ¿Válvulas soportadas o no soportadas?" @default.
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