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Mitrev, Z K1; Anguseva, T N1; Petrovski, V1; Jovanovska, S1; Ampova, V1; Batista, R V2

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Aim: The aim of study was to evaluate clinical results of pts with implanted real stentless aortic valve. Methods: We created our stentless valve using porcine pericardium and replacing valve cusps on patient's aortic fibrous ring. We named it real stentless, because we use patient's aorta ring for its sizing. Radius of aortic ring is measured at aortic base and multiplied by 3, which gives 3cusps length. Than 2cm wide porcine pericardium is cut by calculated length, folded 3times and tailored in shape of heart. Leaflets are implanted using continuous sutures at newly created commissurae, keeping normal Valsalva sinuses. Including criteria for study was:aortic valvular stenosis. Pts, were monitored by TEE. Re-sults:38pts with aortic stenosis(21-atherosclerotic, 15-rheumatic ethyology, 2-subacute endocarditis and chronic haemodyalisis)had been included in study. Intraoperative TEE showed aortic morphology similar as normal, dp/dt ratio was 0.07,equal opening and closing time, average valve systolic gradient was 18. Middle aorta cross-clamping time was 87 min, and bypass time-105 min. Average extubating time was 6h. Significant bleeding was noted in 2pts.Stroke and rhythm disturbances notified at 1pt. Pts have been treated with aspirin 0.1 mg/day.1pt reoperated, due to severe aortic regurgitation. Follow up period 1-24m. Conclusions:Real stentless aortic valve is a bio-prostheses with similar haemodynamic parameters as normal va 1ve.h ensures larger indexed effective aorta orifice area longer follow-up is requiring assessing durability of unstented pericardium in aortic position.

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