Freestyle valve experience: Technical considerations and mid-term results

Background: Many studies have demonstrated the superior hemodynamics of ste ntless porcine aortic valves compared to stented valves. This article descr ibes the operative techniques and reviews our 5-year experience with the Me dtronic Freestyle stentless valve. Methods: Between January 1993 and Novemb er 1997, 95 patients underwent implantation of the Medtronic Freestyle valv e at a mean age of 76 years. All patients were seen at 6 months, 1 year, an d annually thereafter for clinical assessment and Doppler echocardiography. Results: There were three operative and ten late deaths (two cardiac and e ight noncardiac). Three strokes and four transient ischemic attacks occurre d in the follow-up period. Four patients had bacteremia that was treated su ccessfully with antibiotics. No patient required reoperation for valve-rela ted problems. Serial echocardiograms revealed a decrease in mean systolic g radients across the valve during the first year and an increase in effectiv e orifice areas. Ninety-one percent of patients had no, or trace, aortic in sufficiency at the time of discharge and this has not increased over time. Conclusion: The Medtronic Freestyle valve has excellent hemodynamics and go od clinical results. In our experience, no patient has required reoperation in a 5-year follow-up.