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Freestyle valve experience: technical considerations and mid-term results
C F Sintek1, T A Pfeffer, G S Kochamba
1Department of Cardiac Surgery, Kaiser Permanente Medical Center, Los Angeles, California, USA.
Background:
Many studies have demonstrated the superior hemodynamics of stentless porcine aortic valves compared to stented valves. This article describes the operative techniques and reviews our 5-year experience with the Medtronic Freestyle stentless valve.
Methods:
Between January 1993 and November 1997, 95 patients underwent implantation of the Medtronic Freestyle valve at a mean age of 76 years. All patients were seen at 6 months, 1 year, and annually thereafter for clinical assessment and Doppler echocardiography.
Results:
There were three operative and ten late deaths (two cardiac and eight noncardiac). Three strokes and four transient ischemic attacks occurred in the follow-up period. Four patients had bacteremia that was treated successfully with antibiotics. No patient required reoperation for valve-related problems. Serial echocardiograms revealed a decrease in mean systolic gradients across the valve during the first year and an increase in effective orifice areas. Ninety-one percent of patients had no, or trace, aortic insufficiency at the time of discharge and this has not increased over time.
Conclusion:
The Medtronic Freestyle valve has excellent hemodynamics and good clinical results. In our experience, no patient has required reoperation in a 5-year follow-up.
