Aortic valve replacement with the freestyle stentless xenograft

Area of Science:

• Cardiovascular Surgery
• Biomedical Engineering

Background:

• Aortic valve replacement is a critical procedure for patients with severe aortic valve disease.
• Bioprosthetic valves are commonly used, but their long-term durability and hemodynamic performance remain areas of focus.
• The Free-style stentless xenograft presents an alternative bioprosthetic option.

Purpose of the Study:

• To evaluate the safety and efficacy of the Free-style stentless xenograft for aortic valve replacement.
• To assess the hemodynamic performance and implantation technique of this novel xenograft.
• To report early and late outcomes in a consecutive patient cohort.

Main Methods:

• A prospective study involving 55 consecutive patients undergoing aortic valve replacement with the Free-style stentless xenograft.
• Implantation involved a "cylinder within a cylinder" technique, with the xenograft inserted into the aortic sinuses.
• Echocardiographic assessment of systolic gradients and regurgitation was performed postoperatively.

Main Results:

• The xenograft was successfully implanted in all patients, including those with complex conditions like calcified aortic roots and concomitant procedures.
• Mean systolic gradients were low across various valve sizes (e.g., 6.5-13 mm Hg).
• No patient experienced more than trivial aortic regurgitation, and hemodynamic function was excellent post-procedure.

Conclusions:

• The Free-style stentless xenograft is a user-friendly and effective option for aortic valve replacement, suitable even for calcified aortic roots.
• The "cylinder within a cylinder" implantation technique is simple, reproducible, and effectively prevents aortic regurgitation.
• The xenograft demonstrates excellent early and mid-term hemodynamic performance with decreasing gradients over time.