[en] [en] BACKGROUND: Stentless aortic bioprostheses were designed to provide enhanced hemodynamic performance and potentially greater longevity. The present report describes the outcomes of patients with the Freestyle stentless bioprosthesis followed for ≤18 years.
METHODS AND RESULTS: Between 1993 and 2011, 430 patients underwent primary aortic valve replacement with a Freestyle bioprosthesis in the subcoronary position. Mean age was 68.2 ± 8.2 years. All of the clinical and echocardiographic data were collected prospectively. Mean overall follow-up was 9.1 ± 4.4 years and was complete in all of the patients. In-hospital mortality was 3.5% (n=15). Overall, 10- and 15-year survival were 60.7% and 35.0%, respectively. Fifty-one patients required reoperation during follow-up, including 27 for structural valve deterioration (SVD). Overall, freedom from reoperation was 91.0% and 75.0% at 10 and 15 years, whereas freedom from reoperation for SVD was 95.9% and 82.3%, respectively. At 10 and 15 years, freedom from reoperation for SVD was 94.0% and 62.6% for patients <60 years of age and 96.3% and 88.4% for patients ≥60 years of age (P=0.002). The median time to explant for SVD was 10.7 years. SVD presented mostly as acute, severe aortic insufficiency attributed to leaflet tear (77.8%). The independent risk factors for reoperation for SVD were age <60 years (P=0.001) and dyslipidemia (P=0.02).
CONCLUSIONS: Aortic valve replacement with the Freestyle bioprosthesis in a subcoronary position provides good long-term clinical and echocardiographic outcomes for patients >60 years of age. Severe aortic insufficiency with leaflet tear is the major mode of SVD leading to reoperation in these patients.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Mohammadi, Siamak; Division of Cardiac Surgery, Quebec Heart and Lung University Institute, 2725 Chemin Ste-Foy, Quebec City, Quebec, Canada G1V 4G5. siamak.mohammadi@fmed.ulaval.ca
Tchana-Sato, Vincent ; Centre Hospitalier Universitaire de Liège - CHU > > Service de chirurgie cardio-vasculaire et thoracique ; Division of Cardiac Surgery, Quebec Heart and Lung University Institute, Laval University, Quebec City, QC G1V 4G5, Canada
Kalavrouziotis, Dimitri; Division of Cardiac Surgery, Quebec Heart and Lung University Institute, Laval University, Quebec City, QC G1V 4G5, Canada
Voisine, Pierre; Division of Cardiac Surgery, Quebec Heart and Lung University Institute, Laval University, Quebec City, QC G1V 4G5, Canada
Doyle, Daniel; Division of Cardiac Surgery, Quebec Heart and Lung University Institute, Laval University, Quebec City, QC G1V 4G5, Canada
Baillot, Richard; Division of Cardiac Surgery, Quebec Heart and Lung University Institute, Laval University, Quebec City, QC G1V 4G5, Canada
Sponga, Sandro; Division of Cardiac Surgery, Quebec Heart and Lung University Institute, Laval University, Quebec City, QC G1V 4G5, Canada
Metras, Jacques; Division of Cardiac Surgery, Quebec Heart and Lung University Institute, Laval University, Quebec City, QC G1V 4G5, Canada
Perron, Jean; Division of Cardiac Surgery, Quebec Heart and Lung University Institute, Laval University, Quebec City, QC G1V 4G5, Canada
Dagenais, François; Division of Cardiac Surgery, Quebec Heart and Lung University Institute, Laval University, Quebec City, QC G1V 4G5, Canada
Language :
English
Title :
Long-term clinical and echocardiographic follow-up of the Freestyle stentless aortic bioprosthesis.
Publication date :
11 September 2012
Journal title :
Circulation
ISSN :
0009-7322
eISSN :
1524-4539
Publisher :
Ovid Technologies (Wolters Kluwer Health), United States
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