Left ventricular remodelling and improvement in Freestyle stentless valve haemodynamics

Xy, Jin; Westaby, Stephen; Dg, Gibson; Pillai, Ravi; Dp, Taggart

doi:10.1016/s1010-7940(97)01218-9

Cited by 31 publications

(9 citation statements)

References 22 publications

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“…These findings corroborate those previously noted by other investigators. 12,15,26,27,[31][32][33] When the data are tabulated according to valve size, the mean transvalvular gradient and EOA are similar to those reported for the Toronto SPV valve 15,26,27 but compare favorably to the Biocor 31 and Prima 13,16 stentless prostheses.…”

Section: Hemodynamicsmentioning

confidence: 63%

Aortic Valve Replacement With the Freestyle Stentless Bioprosthesis : Five-Year Experience

Yun

Sintek²,

Fletcher³

et al. 1999

Circulation

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Background-Stentless aortic valves were designed to provide a more physiological flow pattern and lower transvalvular gradient, which may have an important bearing on postoperative left ventricular function and remodeling. In this study, we prospectively analyzed the 5-year clinical results with the Freestyle valve (Medtronic, Inc) and its hemodynamic performance by serial echocardiography. Methods and Results-Between January 1993 and August 1997, 95 patients with a mean age of 75 years underwent aortic valve replacement with the Freestyle prosthesis. Sixty-four percent of patients received valves Յ23 mm, and 37% had concomitant coronary artery bypass grafting. Average follow-up was 44Ϯ18 months (meanϮSD), and echocardiography was performed preoperatively, at discharge, at 3 to 6 months, and annually thereafter. The 30-day operative mortality rate was 3%, with an overall actuarial survival rate of 80Ϯ6% (meanϮSEM) at 5 years. Of the 10 late deaths, only 2 were cardiac related, thereby yielding a freedom from cardiac mortality of 94Ϯ3% after 5 years. No patient required reoperation on the aortic valve for any reason, including structural degeneration, nonstructural dysfunction, or prosthetic valve endocarditis. There were 9 thromboembolic and 3 anticoagulant-related bleeding events, none of which was fatal. The actuarial freedom from valve-related morbidity and mortality was 79Ϯ4% at 5 years. Hemodynamically, the mean transvalvular gradient significantly decreased after valve replacement and was reduced further by 41% by 6 months with a corresponding increase in effective orifice area. Left ventricular mass index fell to 75% of the preoperative value by 2 years. Conclusions-TheFreestyle stentless valve can be implanted safely in the elderly with excellent midterm clinical results. It has superb hemodynamics in terms of residual transvalvular gradient, effective orifice area, and regression of left ventricular hypertrophy. (Circulation. 1999;100[suppl II]:II-17-II-23.)

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Section: Hemodynamicsmentioning

confidence: 63%

Aortic Valve Replacement With the Freestyle Stentless Bioprosthesis : Five-Year Experience

Yun

Sintek²,

Fletcher³

et al. 1999

Circulation

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“…Some investigators have reported a negligible pressure drop and nearly perfect relief of LVH after stentless xenograft valve implantation [20,21]. However, investigations on blood pressure were omitted in those papers and no wide consensus exists on this matter at present [22].…”

Section: Discussionmentioning

confidence: 99%

Impact of postoperative blood pressure control on regression of left ventricular mass following valve replacement for aortic stenosis

Imanaka

Kohmoto

Nishimura

et al. 2005

European Journal of Cardio-Thoracic Surgery

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“…An early reduction in hypertrophy thus seemed to lead to superior ventricular function, and may result in a better prognosis for the patient. 1,6 In our experience, however, there was one patient who had a residual peak pressure gradient of more than 30 mmHg after implantation of a 21 mm Freestyle" bioprosthesis using a root inclusion technique, Her body surface area was 1.56 m-, which was larger than 2 other patients (1.21 m 1 and 1.40 m') who had the same size of bioprosthesis implanted with no significant residual transvalvular gradient. It seems that a full root technique was preferable in this case because it allowed for a larger size of bioprosthesis than the other implantation techniques, We used this bioprosthesis for two patients with active endocarditis.…”

Section: Discussionmentioning

confidence: 66%

Early experience of aortic valve replacement with the freestyle® stentless aortic bioprosthesis in elderly patients

Ohtake

Sawa

Sakaguchi

et al. 2000

Jpn J Thorac Caridovasc Surg

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Left ventricular remodelling and improvement in Freestyle stentless valve haemodynamics

Cited by 31 publications

References 22 publications

Aortic Valve Replacement With the Freestyle Stentless Bioprosthesis : Five-Year Experience

Aortic Valve Replacement With the Freestyle Stentless Bioprosthesis : Five-Year Experience

Impact of postoperative blood pressure control on regression of left ventricular mass following valve replacement for aortic stenosis

Early experience of aortic valve replacement with the freestyle® stentless aortic bioprosthesis in elderly patients

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