Midterm outcome after aortic root replacement with stentless porcine bioprostheses
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Objective: Midterm clinical outcome was evaluated after aortic root replacement with Freestyle ® stentless aortic root bioprostheses. Methods: Between April 1996 and December 2007, 301 patients underwent aortic valve replacement with stentless Medtronic Freestyle ® bioprostheses in full-root technique at a single center. Concomitant coronary artery bypass grafting (CABG) was required in 96 patients (32%). In 94 patients (31%), the ascending aorta was replaced. The mean age was 71.6±9.1 (range: 36-89) years. Follow-up was closed in October 2008, 99% complete and encompassed 916 patient-years. Results: Overall mortality within 30 days was 5%. A total of 62 patients died during the follow-up period. Overall survival at 5 and 9 years was 74±4% and 53±6%, respectively. Re-operations were required in three patients: in one patient due to structural valve deterioration, and in two patients due to prosthetic valve endocarditis. Non-structural dysfunctions were not observed. In eight patients, prosthetic valve endocarditis occurred, in most of them (N=6) during the first year after surgery. Rate of freedom from re-operation, structural valve deterioration, prosthetic valve endocarditis, thrombo-embolic and major bleeding events at 9 years was 94±6%, 94±6%, 94±3%, 87±5%, and 95±2%, respectively. The linearized rates of late adverse events in percent per patient-year were 0.35, 0.12, 0.83, 1.7, and 0.7, respectively, for re-operation, structural valve deterioration, prosthetic valve endocarditis, thrombo-embolic and major bleeding events. A little less than a quarter (22%) of the patients required anticoagulation therapy. Conclusions: Aortic root replacement with the stentless Freestyle ® bioprosthesis provided a respectable short-term mortality, optimal valve durability and acceptable rates of valve-related complications within 9 years.
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Ennker, J.; Albert, A.; Rosendahl, U.; Ennker, I.; Dalladaku, F.; Florath, Ines (2008)Background: We compared the midterm outcome after aortic valve replacement with the Freestyle stentless bioprosthesis for the full-root or subcoronary implantation technique, while adjusting for patient and disease ...
The freestyle stentless bioprosthesis in more than 1000 patients: A single-center experience over 10 yearsEnnker, J.; Ennker, I.; Albert, A.; Rosendahl, U.; Bauer, S.; Florath, Ines (2009)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 ...
Gulbins, H.; Florath, Ines; Ennker, J. (2008)Background: One major advantage of biologic aortic valve prostheses is their low thrombogenicity compared with mechanical prostheses. The purpose of this study was to evaluate the incidence of cerebrovascular events during ...