Frühergebnisse mit der gerüstfreien Bioprothese vom Typ Freestyle TM

Abstract

Background: Stentless porcine aortic valves are considered to be hemodynamically superior to mounted bioprostheses.¶Methods: From May 1996 to June 1997, 58 consecutive patients underwent aortic valve replacement with the Freestyle stentless bioprosthesis in the subcoronary position. Mean age was 73,8 years (range 61–84). The predominant aortic valve lesion was stenosis in 29 and regurgitation in 10 cases. A combined lesion was found in 19 patients. All patients were examined clinically and by echocardiography 1 week, 6 months, and 1 year postoperatively.¶Results: Additional coronary artery bypass grafting was performed in 26 patients. Mean cross-clamp time was 55 min (range 41–95) for AVR and 71 min (range 52–103) with additional CABG. The inhospital mortality rate was 7% (4/58). Thromboembolism, hemorrhage, endocarditis or structural valve deterioration did not occur. At one year 41% were in NYHA class I, 53% in NYHA class II. Minimal aortic valve incompetence was seen in 19% postoperatively, in 14% at 6 months and in 9% at 1 year. There was no case of severe regurgitation.¶Conclusions:The Freestyle stentless bioprosthesis shows good results both hemodynamicaly and clinically. Pressure gradients are decreasing and most of the Patients are in NYHA functional class I or II postoperatively. Perioperative mortality is low and no valve related complications occured suggesting this type of valve to be safe. Whether this promising valve can live up its expectations has yet to be determined in long-term follow-up studies.