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Updated: Jul 19, 2026
Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
Stentless bioprostheses have ideal haemodynamics, even in the small aortic root
L H Baur1, Y Houdas, K H Peels
1Department of Cardiology, Atrium Medical Centre, Heerlen, The Netherlands. lhbaur@yahoo.com
Objective:
To determine normal Doppler and 2D gradients and flow characteristics of the Freestyle stentless aortic bioprosthesis related to valve size.
Background:
The Freestyle stentless aortic bioprosthesis is one of the newer aortic xenografts. Only limited data are available of the echocardiographic flow characteristics during a mid-term follow-up period of this valve. Therefore valve performance related to valve size was measured during a follow-up period of two years.
Methods:
175 consecutive patients with a Freestyle aortic bioprosthesis underwent an echocardiographic and Doppler examination according to a common protocol. Investigations were done within 4 weeks after operation, after 3 to 6 months, and after 1 and 2 years.
Results:
With a valve size from 19 to 27 mm mean gradients decreased from 8.0 +/- 5.1 mmHg at discharge to 5.8 +/- 3.8 mmHg after 3-6 months (p < 0.001). Thereafter gradients remained stable. The performance index, the ratio of the measured effective orifice area in the patient divided by the effective orifice area measured in vitro increased from 69 +/- 20% at discharge to 79 +/- 29% after one, two and three years. Performance index was especially very high in the smaller sized valves with a performance index of 85 +/- 17% for the 21 mm valve. During follow-up mean gradients remained below 10 mmHg even in the 21 mm valve.
Conclusion:
Stentless xenografts have ideal haemodynamics, even in the small aortic root.
