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Ann Thorac Surg 1999;67:1609-1615
© 1999 The Society of Thoracic Surgeons

Original Articles

Aortic root replacement with the freestyle stentless porcine aortic root bioprosthesis

Neal D. Kon, MDa, A. Robert Cordell, MDa, Sandy M. Adair, RNa, John E. Dobbins, PA-Ca, Dalane W. Kitzman, MDb

a Department of Cardiothoracic Surgery, Wake Forest University School of Medicine/Baptist Medical Center, Winston-Salem, North Carolina, USA
b Section of Cardiology, Wake Forest University School of Medicine/Baptist Medical Center, Winston-Salem, North Carolina, USA

Address reprint requests to Dr Kon, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1096;
e-mail: nkon{at}wfubmc.edu

Presented at the Forty-fifth Annual Meeting of the Southern Thoracic Surgical Association, Orlando, FL, November 12–14, 1998.

Background. Stentless porcine prosthetic valves offer several advantages over traditional valves. Among these are superior hemodynamics, laminar flow patterns, lack of need for anticoagulation and perhaps improved durability.

Methods. One hundred and twelve patients were operated on from September 17, 1992 to April 13, 1998 as part of a multi-center worldwide investigation. All patients received a total aortic root replacement. Patients were evaluated postoperatively at discharge, 3 to 6 months, and yearly by clinical exam and color flow Doppler echocardiography.

Results. There were 4 deaths either in the hospital or within 30 days after surgery for an operative mortality of 3.6%. No patients experienced structural valve deterioration, non-structural valve deterioration, paravalvular leak, unacceptable hemodynamic performance, or postoperative endocarditis. The linearized rates for survival and thromboembolic complications at 5 years were 82.8% and 90.5% respectively. Excellent hemodynamic function is demonstrated by very low gradients, large EOA, and an exceedingly low incidence of any aortic regurgitation.

Conclusions. The Medtronic Freestyle aortic root bioprosthesis can be used safely to replace the aortic root for aortic valve and aortic root pathology. Root replacement allows optimal hemodynamic performance with no significant aortic regurgitation. Early and intermediate results are encouraging, but further follow-up is needed to determine valve durability.




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