Pulmonary-Valve Replacement in Adults: Results With the Medtronic Freestyle Valve

Cardiac surgery for infective endocarditis in patients with intravenous drug use

“…All patients undergoing aortic full root implantation received a Medtronic Freestyle (Medtronic, Inc., Minneapolis, MN, USA), whereas 1 patient received a homograft in the pulmonary position. Although the lack of availability of homografts decided the limited number of this type of prosthesis, the porcine full root prosthesis has become accepted as an alternative to homografts in both the pulmonary and aortic position [24,25].…”

Pulmonary Allograft Versus Medtronic Freestyle Valve in Surgical Pulmonary Valve Replacement for Adults Following Correction of Tetralogy of Fallot or Its Variants

“…Our findings on the pulmonary homograft were consistent with other studies which reported excellent freedom from reintervention, 13,15 substantially better than that of Zubairi et al, 10 which included children, a known risk factor for valve reintervention. 8 The Medtronic Freestyle also had excellent outcomes previously observed by Ramanan et al 6 who found 96% freedom from reintervention at five years. They too found that the average peak RVOT gradient measured by pulsed wave Doppler was 18.7 + 8.8 mm Hg at a mean follow-up of three years, somewhat lower than our average PPG of 32.1 + 15.9 mm Hg at a mean follow-up of 4.8 + 2.6 years.…”

“…This average PPG was significantly higher when compared with the pulmonary allograft reading of 23.1 + 12.8 mm Hg at a mean follow-up of 10.2 + 5.9 years and counters the suggestion that the stentless design may lead to reduced transvalvular gradients. 5,6 In addition, early postinflammatory and immunological reactions to a heterograft valve may also be important. 6 The Medtronic Freestyle has been reported to have reduced flexibility and a thicker profile compared to the homograft valve.…”

“…5,6 In addition, early postinflammatory and immunological reactions to a heterograft valve may also be important. 6 The Medtronic Freestyle has been reported to have reduced flexibility and a thicker profile compared to the homograft valve. 6 It has been suggested that the shorter length of the conduit can cause turbulence and shrinkage at the proximal anastomosis, especially when used without an infundibular hood, contributing to stenosis and valve failure.…”

“…5 The Medtronic Freestyle is a bioprosthetic valve derived from an aortic porcine root and treated with alpha-amino oleic acid to reduce calcification. 5 The suggested benefits of this valve include its stentless design to achieve a greater orifice and a reduced transvalvular gradient 6 Abbreviations and Acronyms and the ability to act as a platform for percutaneous PVR if required. 5 Although used extensively at the aortic site, there is little data on its insertion at the pulmonary site.…”