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  • Title: Impact of intraoperative post-pump aortic regurgitation with stentless aortic bioprostheses.
    Author: Bach DS, LeMire MS, Eberhart D, Armstrong WF, Deeb GM.
    Journal: Semin Thorac Cardiovasc Surg; 1999 Oct; 11(4 Suppl 1):88-92. PubMed ID: 10660173.
    Abstract:
    Stentless aortic bioprosthesis performance may be affected by geometric distortion, and intraoperative echocardiography typically is used to assess prosthetic valve function. The impact of minimal or mild post-pump aortic regurgitation has not been previously investigated. Intraoperative post-pump transesophageal echocardiograms and follow-up transthoracic echocardiograms (up to 3 years' postoperatively) were reviewed for 96 patients who underwent implantation of Freestyle (Medtronic) stentless aortic bioprostheses. Minimal or mild aortic regurgitation was present post-pump in 50 of 96 (52%) patients. On early follow-up examination (n = 80), no patient had more than mild aortic regurgitation. Aortic regurgitation had completely resolved in 24 of 39 (62%) patients with post-pump aortic regurgitation, including 15 of 19 (79%) patients with minimal paravalvular regurgitation. The incidence of mild aortic regurgitation at 2 and 3 years did not appear different between patients with and those without post-pump aortic regurgitation. Minimal or mild aortic regurgitation is common on intraoperative post-pump transesophageal echocardiography immediately after implantation of stentless aortic bioprostheses. Resolution is common, especially of small paravalvular jets. Minimal or mild post-pump aortic regurgitation infrequently results in even mild aortic regurgitation on early follow-up evaluation and does not appear to predict clinically significant progression of aortic regurgitation on long-term follow-up evaluation.
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