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Published on: October 22, 2017
Aortic valve replacement with the freestyle stentless bioprosthesis: five-year experience
K L Yun1, C F Sintek, A D Fletcher
1Department of Cardiac Surgery, Kaiser Permanente Medical Center, Los Angeles, CA 90027, USA. Kwok.L.Yun@KP.org
Circulation
|November 24, 1999
Summary
The Freestyle stentless aortic valve offers excellent 5-year clinical outcomes and hemodynamic performance in elderly patients. This valve replacement surgery demonstrates good survival rates and significant reduction in left ventricular hypertrophy.
Area of Science:
- Cardiovascular Surgery
- Biomaterials in Medicine
- Medical Device Technology
Background:
- Stentless aortic valves aim for physiological flow and reduced transvalvular gradients.
- Potential benefits include improved postoperative left ventricular function and remodeling.
- The Freestyle valve (Medtronic, Inc) was evaluated for clinical and hemodynamic outcomes.
Purpose of the Study:
- To prospectively analyze 5-year clinical results of the Freestyle stentless aortic valve.
- To assess the hemodynamic performance of the Freestyle valve using serial echocardiography.
Main Methods:
- Prospective study of 95 elderly patients (mean age 75 years) undergoing aortic valve replacement with the Freestyle prosthesis.
- Echocardiography performed preoperatively, at discharge, and at regular intervals up to 5 years.
- Analysis of clinical outcomes including mortality, reoperation rates, and valve-related morbidity.
Main Results:
- 3% 30-day operative mortality and 80% 5-year actuarial survival.
- 94% freedom from cardiac mortality and 79% freedom from valve-related morbidity/mortality at 5 years.
- Significant reduction in transvalvular gradient and left ventricular mass index, with increased effective orifice area.
Conclusions:
- The Freestyle stentless valve is safely implanted in the elderly.
- Excellent midterm clinical and hemodynamic results were observed.
- Superb hemodynamics include reduced gradients, improved orifice area, and regression of left ventricular hypertrophy.
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