The freestyle stentless bioprosthesis in more than 1000 patients: A single-center experience over 10 years
Background and Aim: Early and mid-term clinical outcomes after aortic valve replacement (AVR) with stentless bioprostheses in a large cohort of patients are presented. Methods: Between April 1996 and November 2005, 1014 patients underwent AVR with the stentless Medtronic Freestyle bioprosthesis, wit...
| Main Authors: | , , , , , |
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| Format: | Journal Article |
| Published: |
2009
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| Online Access: | http://hdl.handle.net/20.500.11937/14468 |
| _version_ | 1848748630744236032 |
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| author | Ennker, J. Ennker, I. Albert, A. Rosendahl, U. Bauer, S. Florath, Ines |
| author_facet | Ennker, J. Ennker, I. Albert, A. Rosendahl, U. Bauer, S. Florath, Ines |
| author_sort | Ennker, J. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Background and Aim: Early and mid-term clinical outcomes after aortic valve replacement (AVR) with stentless bioprostheses in a large cohort of patients are presented. Methods: Between April 1996 and November 2005, 1014 patients underwent AVR with the stentless Medtronic Freestyle bioprosthesis, with 168 using the full-root technique. The mean age was 73 ± 3 (range: 20 to 90) years. Follow-up included 2953 patient-years and was 95% complete for adverse events. Results: Operative mortality was 3.4% (N = 34). Overall survival was 46 ± 9% at nine years and similar to age- and gender-matched German general population. Freedom from prosthetic valve endocarditis, major bleeding, neurological events, and reoperation after nine years was 97 ± 6%, 92 ± 7%, 70 ± 16%, and 92 ± 9%, respectively. Freedom from structural valve deterioration was 97 ± 5% at 9 years. During the learning phase, mean transprosthetic gradients of 23.5 ± 3.0 mmHg and 24.8 ± 3.1 mmHg were observed for valve sizes 21 and 23 mm, respectively, 10 days after subcoronary implantation in 1997, which could be lowered to 16 ± 2.1 mmHg and 14.9 ± 0.9 mmHg in 2005, respectively, with increasing experience of the surgeons. During the follow-up period, mean gradients dropped on average by 15 mmHg in patients presenting higher gradients at discharge. Conclusions: The Freestyle stentless bioprosthesis showed encouraging midterm durability with low rates of valve-related morbidity, and can be safely implanted without increased operative risk even during the learning phase. Special training of the surgeons is recommended to achieve optimal hemodynamic performance. © 2008 Wiley Periodicals, Inc. |
| first_indexed | 2025-11-14T07:08:06Z |
| format | Journal Article |
| id | curtin-20.500.11937-14468 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T07:08:06Z |
| publishDate | 2009 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-144682017-09-13T15:02:45Z The freestyle stentless bioprosthesis in more than 1000 patients: A single-center experience over 10 years Ennker, J. Ennker, I. Albert, A. Rosendahl, U. Bauer, S. Florath, Ines Background and Aim: Early and mid-term clinical outcomes after aortic valve replacement (AVR) with stentless bioprostheses in a large cohort of patients are presented. Methods: Between April 1996 and November 2005, 1014 patients underwent AVR with the stentless Medtronic Freestyle bioprosthesis, with 168 using the full-root technique. The mean age was 73 ± 3 (range: 20 to 90) years. Follow-up included 2953 patient-years and was 95% complete for adverse events. Results: Operative mortality was 3.4% (N = 34). Overall survival was 46 ± 9% at nine years and similar to age- and gender-matched German general population. Freedom from prosthetic valve endocarditis, major bleeding, neurological events, and reoperation after nine years was 97 ± 6%, 92 ± 7%, 70 ± 16%, and 92 ± 9%, respectively. Freedom from structural valve deterioration was 97 ± 5% at 9 years. During the learning phase, mean transprosthetic gradients of 23.5 ± 3.0 mmHg and 24.8 ± 3.1 mmHg were observed for valve sizes 21 and 23 mm, respectively, 10 days after subcoronary implantation in 1997, which could be lowered to 16 ± 2.1 mmHg and 14.9 ± 0.9 mmHg in 2005, respectively, with increasing experience of the surgeons. During the follow-up period, mean gradients dropped on average by 15 mmHg in patients presenting higher gradients at discharge. Conclusions: The Freestyle stentless bioprosthesis showed encouraging midterm durability with low rates of valve-related morbidity, and can be safely implanted without increased operative risk even during the learning phase. Special training of the surgeons is recommended to achieve optimal hemodynamic performance. © 2008 Wiley Periodicals, Inc. 2009 Journal Article http://hdl.handle.net/20.500.11937/14468 10.1111/j.1540-8191.2008.00732.x restricted |
| spellingShingle | Ennker, J. Ennker, I. Albert, A. Rosendahl, U. Bauer, S. Florath, Ines The freestyle stentless bioprosthesis in more than 1000 patients: A single-center experience over 10 years |
| title | The freestyle stentless bioprosthesis in more than 1000 patients: A single-center experience over 10 years |
| title_full | The freestyle stentless bioprosthesis in more than 1000 patients: A single-center experience over 10 years |
| title_fullStr | The freestyle stentless bioprosthesis in more than 1000 patients: A single-center experience over 10 years |
| title_full_unstemmed | The freestyle stentless bioprosthesis in more than 1000 patients: A single-center experience over 10 years |
| title_short | The freestyle stentless bioprosthesis in more than 1000 patients: A single-center experience over 10 years |
| title_sort | freestyle stentless bioprosthesis in more than 1000 patients: a single-center experience over 10 years |
| url | http://hdl.handle.net/20.500.11937/14468 |