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The Journal of Thoracic and Cardiovascular Surgery, Vol 109, Issue 5 871-876, Copyright © 1995 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
NOTE: The fulltext of this article is not available online.
C. F. Sintek, A. D. Fletcher and S. Khonsari
The Medtronic Freestyle bioprosthesis is a stentless porcine aortic root
cross-linked in dilute glutaraldehyde solution with stress-free fixation
for the valve leaflets. It has been treated by a process in which amino
oleic acid is used to reduce the potential for calcification. As a complete
aortic root, it has the same versatility as the aortic homograft but has
the advantage that it is readily available in all sizes to the implanting
surgeon. Between January 1993 and May 1994, we implanted 64 Freestyle
bioprostheses as aortic valve replacements using a freehand technique; 5
size 19 mm, 15 size 21 mm, 16 size 23 mm, 13 size 25 mm, and 15 size 27 mm
valves were used. There were 35 men and the mean age was 75.7 years (64 to
84 years). The operative mortality was 3.1% (2/64). Echocardiograms at the
time of discharge revealed mean aortic valve gradients ranging from 18.2 mm
Hg for 19 mm to 10.3 mm Hg for 27 mm valves. Effective orifice areas ranged
from 1.0 cm2 for 19 mm to 2.0 cm2 for 27 mm valves. No patient had more
than trace aortic insufficiency. Our early experience with this new
stentless bioprosthesis shows it to have excellent hemodynamics especially
in the smaller valve sizes. Using this valve in patients who have a small
aortic root and require a tissue valve avoids the need for aortic root
enlargement procedures.
CLINICAL TRIAL
Stentless porcine aortic root: valve of choice for the elderly patient with small aortic root?
Regional Department of Cardiac Surgery, Kaiser Permanente Medical Center, Los Angeles, Calif 90027, USA.
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