| Long-term clinical and echocardiographic follow-up of the freestyle stentless aortic bioprosthesis. | |
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MedLine Citation:
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PMID: 22965983 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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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. |
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Authors:
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Siamak Mohammadi; Vincent Tchana-Sato; Dimitri Kalavrouziotis; Pierre Voisine; Daniel Doyle; Richard Baillot; Sandro Sponga; Jacques Metras; Jean Perron; François Dagenais |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Circulation Volume: 126 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2012 Sep |
Date Detail:
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Created Date: 2012-09-11 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: S198-204 Citation Subset: AIM; IM |
Affiliation:
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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. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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