Objectives: Stentless bioprostheses have been gaining popularity in recent years as hemodynamically superior alternatives to conventional stented bioprostheses.Methods: Between July 1996 and November 1998, 13 patients with aortic valve disease, 7 males and 6 females with a mean age (±SD) of 68 ± 5 years, underwent an aortic valve replacement using the Medtronic Freestyle® aortic bioprosthesis. The predominant lesions were stenosis in 8 patients and regurgitation in 5, while 2 patients had endocarditis. The operation was performed by a subcoronary technique in 9, root-inclusion technique in 3, and full root technique in 1 patient.Results: Throughout the follow-up periods (with average follow-up period of 20.6 months), there was no hospital mortality, though there was one late death of unknown cause. The New York Heart Association class improved in all patients. The peak transvalvular gradient decreased from 18.4 ± 9.8 to 12.6 ± 9.6 mmHg, and the effective valve orifice area increased from 2.30 ± 0.96 to 2.59 ± 1.05 cm2 between the 1-month and the 6-month follow-up examinations. In patients with aortic regurgitation, the left ventricular end-diastolic/end-systolic volume index significantly decreased from 147 ± 36/62 ± 19 to 73 ± 26/33 ± 14 ml/m2 at 1 month after the operation. The left ventricular mass index also significantly decreased from 189 ± 26 to 143 ± 30 g/m2 in patients with aortic regurgitation and from 171 ± 28 to 144 ± 30 g/m2 in those with aortic stenosis.Conclusions: Although long-term follow-up is required for further evaluation, the early results appeared to indicate that the Freestyle® aortic bioprosthesis was suitable for elderly patients requiring aortic valve replacement.
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Sintek CF, Flether AD, Khonsari S. Stentless porcine aortic root: valve of choice for the elderly patient with small aortic root? J Thorac Cardiovasc Surg 1995; 109: 871–6.
Walther T, Fald V, Diegeler A, Gummert J, Autschbach R, Mohr FW. Stentless valve replacement in the small aortic root. Cardiovasc Surg 1997; 5: 229–34.
Westaby S, Amarasena N, Long V, Prothero A, Amarasena GA, Ormerod O, et al. Time-related hemo-dynamic changes after aortic replacement with the Freestyle stentless xenograft. Ann Thorac Surg 1995; 60: 1633–9.
Del Rizzo DF, Goldman BS, Christakis GT, David TE. Hemodynamic benefits of the Toronto stentless valve. J Thorac Cardiovasc Surg 1996; 112: 1431–6.
Jin XY, Zhang ZM, Gibson DG, Yacoub MH, Pepper JR. Effects of valve substitute on changes in left ventricular function and hypertrophy after aortic valve replacement. Ann Thorac Surg 1996; 62: 683–90.
Jin XY, Westaby S, Gibson DG, Pillai R, Taggart DP. Left ventricular remodelling and improvement in Freestyle stentless valve haemodynamics. Eur J Cardio-thorac Surg 1997; 12: 63–9.
Westaby S, Amarasena N, Ormerod O, Amaraseca GA, Pillai R. Aortic valve replacement with the Freestyle stentless xenograft. Ann Thorac Surg 1995; 60: S422–7.
David TE, Armstrong S, Sun Z. Clinical and hemodynamic assessment of the Hancock II bioprosthesis. Ann Thorac Surg 1992; 54: 661–8.
Kon ND, Westaby S, Amarasena N, Pillai R, Cordell AR. Comparison of implantation technique using Freestyle stentless porcine aortic valve. Ann Thorac Surg 1995; 59: 857–62.
Barner HB, Labovitz AJ, Fiore AC. Prosthetic valves for the small aortic root. J Cardiac Surg 1994; 9: 154–7.
Sakaguchi T, Sawa Y, Ohtake S, Hirata N, Matsuda H. The Freestyle stentless bioprosthesis for prosthetic valve endocarditis. Ann Thorac Surg 1999; 67: 533–5.
Santini F, Musazzi A, Bertolini P, Pugliese P, Fabbri A, Faggian G, et al. Stentless porcine bioprosthesis in the treatment of aortic valve infective endocarditis. J Card Surg 1995; 10: 205–9.
Lupinetti FM, Lemmer JH. Comparison of allografts and prosthetic valves when used for emergency aortic valve replacement for active infective endocarditis. Am J Cardiol 1991; 68: 637–41.
Bedi HS, Farnsworth AE. Homograft aortic root replacement for destructive prosthetic endocarditis. Ann Thorac Surg 1993; 55: 386–8.
Pagano D, Allen M, Bonser S. Homograft aortic valve and root replacement for severe destructive native or prosthetic endocarditis. Eur J Cardio-thorac Surg 1994; 8: 173–6.
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Ohtake, S., Sawa, Y., Sakaguchi, T. et al. Early experience of aortic valve replacement with the freestyle® stentless aortic bioprosthesis in elderly patients. Jpn J Thorac Caridovasc Surg 48, 222–228 (2000). https://doi.org/10.1007/BF03218126
- Freestyle® bioprosthesis
- stentless valve
- aortic valve replacement