Objectives: The aim of this retrospective study was to evaluate the early, intermediate and long term clinical performancfdefe of the first 128 consecutively implanted valves using Freedom SOLO aortic valve.
Methods: Between October 2006 and February 2010, a total of 128 patients (64 men, 64 women, mean age 75,85 ± 5,17 years) underwent aortic valve replacement using Freedom SOLO valve. Clinical, operative and echocardiographic data were prospectively recorded. Follow-up time was 29,72 ± 1,25 months.
Results: The mean BSA was 1,79 ± 0,21 m2 and the mean NYHA class 2,06 ± 0,70. Concomitant procedures were performed in 77 patients (60,2%). The mean standard EuroSCORE was 9,04 ± 2,70. Grade 3 aortic stenosis was present in 93 patients (72,7%). Mean cross-clamp time for isolated Freedom SOLO aortic valve implantation was 52,71 ± 11,94 minutes and 80,46 ± 28,33 minutes concomitant procedures and mean cardiopulmonary by-pass time was 103,28 ± 31,27 minutes. The mean implanted valve size was 22,65 ± 1,48 mm. Mean ICU and hospital stay were 2,42 ± 1,1 days and 8,84 ± 2,61 respectively. Three patients were reoperated for bleeding. The 15-day, 30-day and perioperatively mortality were 4,6% respectively (6 patients). Two patients died due to cardiogenic shock, two due to multi organ failure and another two due to hemorrhage. The 3 year survival was 93 ± 1,1% for the low EuroSCORE (<6) cohort and 90 ± 0,81% for the high EuroSCORE (>6) cohort. Echocardiographic data preoperative, immediately postoperatively and at 3, 6, 12 months showed peak transvalvular gradients of 75,34 ± 23,54, 16,81 ± 5,63, 18,18 ± 6,51, 16,06 ± 6,33 and 17,94 ± 9,14 mmHg respectively (p< 0,001). There were only three cases of early mild aortic regurgitation (Grade 1), which remained stable at 12 months.
Conclusions: Supra annular implantation of the Freedom SOLO stentless aortic valve has excellent early, intermediate and long term results. The reduced cross clamp time and the excellent hemodynamic profile represent an attractive surgical alternative in elderly and sicker patients.
The early, intermediate and long term results of a single centre with freedom solo valve: What have we learned from 128 cases ?Iliopoulos C Dimitrios, Deveja Aris, Kastellanos Eleftherios, Satratzemis Vasilios, Androutsopoulou Vasiliki, Filias Vasilios, Demis Agron Alexandros, Manna Ibrahim, Koudoumas Dimitrios
University of Athens, Athens, Greece |