Long-term outcomes using the stentless LivaNova-Sorin Pericarbon Freedom™ valve after aortic valve replacement†

Stefanelli, Guglielmo; Pirro, Fabrizio; Olaru, Alina; D'Anniballe, G; Labia, Clorinda; Weltert, Luca

doi:10.1093/icvts/ivy012

Cited by 9 publications

(4 citation statements)

References 22 publications

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“…4 We have a large experience with SPF stentless valve, with more than 322 implants. 5 Our experience with SPF, consisting entirely of Freedom valves, started in 2003; therefore, we began to see an increasing number of patients reaching the limits of the prosthesis durability. In our experience, the more frequent failure mode of the SPF is a calcified cusp tearing, usually the left, causing a sudden and severe aortic incompetence responsible for a clinical condition of acute heart failure ( Fig.…”

Section: Discussionmentioning

confidence: 99%

Successful Reoperation in 3 Cases of Failed Sorin Freedom Stentless Aortic Valve Using the LivaNova Perceval Sutureless Prosthesis

Stefanelli

Pirro

Smorto

et al. 2020

Innovations�(Phila)

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Reoperations for deteriorated stentless bioprostheses are quite challenging procedures. Calcification of the aortic annulus and of the subcoronary root makes often impossible the removal of the failed valve, living a complex Bentall operation or a high-risk transcatheter aortic valve implantation valve-in-valve procedure as the only options, particularly in cases of small-size prostheses. The Perceval sutureless prosthesis (LivaNova PLC, London, UK) can be a valid alternative for failed stentless valve replacement. We report our experience with 3 complex cases of degenerated Sorin Pericarbon Freedom prosthesis treated successfully by means of Perceval sutureless implantation and demonstrating the reproducibility and the safety of this surgical approach.

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Section: Discussionmentioning

confidence: 99%

Successful Reoperation in 3 Cases of Failed Sorin Freedom Stentless Aortic Valve Using the LivaNova Perceval Sutureless Prosthesis

Stefanelli

Pirro

Smorto

et al. 2020

Innovations�(Phila)

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“…We concluded that SPF is a valuable aortic bioprosthesis, particularly indicated in cases of small annulus in patients with large BSA. 28 Despite reinterventions for replacement of a failed bioprosthesis carry a low mortality rate nowadays, transcatheter valve-in-valve procedures (TAVI-VIV) have become the treatment of first choice to replace a failing bioprosthesis, particularly for older patients with associated comorbidities. 29 In cases of CEP failure the technique is well codified and associated with acceptable results even in size 19 and 21.…”

Section: Discussionmentioning

confidence: 99%

Stentless Pericarbon Freedom Versus Stented Perimount Aortic Bioprosthesis: Propensity-Matched Long-Term Follow-Up

Stefanelli

Pirro

Smorto

et al. 2020

Innovations�(Phila)

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Objective Stentless aortic valves have shown superior hemodynamic performance and faster left ventricular mass regression compared to stented bioprostheses. Yet, controversies exist concerning the durability of stentless valves. This case-matched study compared short- and long-term clinical outcomes of stentless LivaNova-Sorin Pericarbon Freedom™ (SPF) and stented Carpentier-Edwards Perimount (CEP) aortic prostheses. Methods From 2003 through 2006, 134 consecutive patients received aortic valve replacement with SPF at our institution. This cohort was matched, according to 20 preoperative clinical parameters, with a control group of 390 patients who received CEP prosthesis during the same time. The resulting 55 + 55 matched patients were analyzed for perioperative results and long-term clinical outcomes. Results Early mortality was 0% for both groups. Lower transvalvular gradients were found in the SPF group (10.6 ± 2.9 versus 15.7 ± 3.1 mmHg, P < 0.001). Overall late mortality (mean follow-up: 10.03 years) was similar for both groups (50.1% versus 42.8%, P = 0.96). Freedom from structural valve degeneration (SVD) at 13 years was similar for both groups (SPF = 92.3%, CEP = 73.9%, P = 0.06). Freedom from aortic valve reinterventions did not differ (SPF = 92.3%, CEP = 93.5%, P = 0.55). Gradients at 13-year follow-up remained significantly lower in SPF group (10.0 ± 4.5 versus 16.2 ± 9.5 mmHg, P < 0.001). Incidence of acute bacterial endocarditis (ABE) and major adverse cardiovascular and cerebrovascular events (MACCE) was similar. Conclusions SPF and CEP demonstrated comparable long-term outcomes related to late mortality, SVD, aortic valve reinterventions, and incidence of ABE and MACCE. Superior hemodynamic performance of SPF over time can make this valve a suitable choice in patients with small aortic root and large body surface area.

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“…A low-profile flexible plastic stent (Delrin) covered by Dacron fabric; two separate sheets of pericardium; anti-calcification treatment with homocysteic acid [56] Severe calcification and cusp tears [ 80,81] 2004 SVD, structural valve degeneration. Balloon-expandable, stented; [ 86,87] lower transaortic peak and mean gradients; built on the Carpentier-Edwards Perimount valve platform; [ 82] leading to a relative reduction in aortic cross-clamp time and cardiopulmonary bypass time [ 83,84] Postoperative pacemaker implantation (6.2%); SVD 1.04% (5-year follow-up); SVD 1.6% (7-to 8-year follow-up) [84] 2016 Perceval Stentless LivaNova, Biomedica Cardio Srl, Saluggia, Italy…”

Section: Sorin Pericarbon Stentless Sorin Biomedicamentioning

confidence: 99%

Recent Advances in the Modification and Improvement of Bioprosthetic Heart Valves

Tong,

Cai,

Wang

et al. 2024

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Valvular heart disease (VHD) has become a burden and a growing public health problem in humans, causing significant morbidity and mortality worldwide. An increasing number of patients with severe VHD need to undergo heart valve replacement surgery, and artificial heart valves are in high demand. However, allogeneic valves from donors are lacking and cannot meet clinical practice needs. A mechanical heart valve can activate the coagulation pathway after contact with blood after implantation in the cardiovascular system, leading to thrombosis. Therefore, bioprosthetic heart valves (BHVs) are still a promising way to solve this problem. However, there are still challenges in the use of BHVs. For example, their longevity is still unsatisfactory due to the defects, such as thrombosis, structural valve degeneration, calcification, insufficient re‐endothelialization, and the inflammatory response. Therefore, strategies and methods are needed to effectively improve the biocompatibility and longevity of BHVs. This review describes the recent research advances in BHVs and strategies to improve their biocompatibility and longevity.

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Long-term outcomes using the stentless LivaNova-Sorin Pericarbon Freedom™ valve after aortic valve replacement†

Abstract: Sorin Pericarbon Freedom is a valuable aortic bioprosthesis with favourable haemodynamics, particularly in smaller annuli, and durability similar to that of stented valves, which make Sorin Pericarbon Freedom a useful option in AVR.

Cited by 9 publications

References 22 publications

Successful Reoperation in 3 Cases of Failed Sorin Freedom Stentless Aortic Valve Using the LivaNova Perceval Sutureless Prosthesis

Successful Reoperation in 3 Cases of Failed Sorin Freedom Stentless Aortic Valve Using the LivaNova Perceval Sutureless Prosthesis

Stentless Pericarbon Freedom Versus Stented Perimount Aortic Bioprosthesis: Propensity-Matched Long-Term Follow-Up

Recent Advances in the Modification and Improvement of Bioprosthetic Heart Valves

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