Thorac Cardiovasc Surg 2005; 53(4): 212-216
DOI: 10.1055/s-2005-837638
Original Cardiovascular

© Georg Thieme Verlag KG Stuttgart · New York

Impact of Implantation Technique on Hemodynamic Results of the Pericarbon Freedom Stentless™ Valve[1]

S. Beholz1 , H. Grubitzsch1 , S. Dushe1 , J. Liu1 , P. M. Dohmen1 , W. Konertz1
  • 1Department of Cardiovascular Surgery, Charité - University Medicine Berlin, Berlin, Germany
Further Information

Publication History

Received October 11, 2004

Publication Date:
22 July 2005 (online)

Abstract

Background: The Pericarbon Freedom stentless valve has shown excellent hemodynamic results in the midterm course. However, there is no information as to whether a continuous or interrupted suture technique at the inflow site has an impact on postoperative hemodynamics. Methods: 139 patients were enrolled in a non-randomized, prospective matched trial. An interrupted suture line technique was used in 68 patients and a continuous suture line technique was used in 71 at the inflow site. Isolated valve replacement was performed in 70.4 % of the continuous and 67.6 % of the interrupted suture group. Pre- and postoperative hemodynamics and one-year follow-up were obtained by echocardiography and expressed as mean and peak gradients and grade of regurgitation. Results: No significant difference between continuous and interrupted suture techniques were noted with respect to mean (11.8 ± 6.3 vs. 12.5 ± 6.2 mm Hg, p = 0.251) and peak gradients (21.0 ± 9.6 vs. 22.0 ± 10.9 mm Hg, p = 0.292) as well as to the degree of regurgitation. Bypass and cross-clamping times decreased by 22.4 and 20.6 minutes, respectively, with the use of the continuous suture technique. One year follow-up showed a further, significant decrease of mean and peak gradients. Conclusions: The Pericarbon Freedom™ stentless valve appears to offer excellent postoperative performance. The suture line technique at the inflow site does not result in any hemodynamic differences.

1 Presented at the Satellite Symposium “Benefits of Bioprostheses” at the 4th joint meeting of the German, Austrian and Swiss Societies for Thoracic and Cardiovascular Surgery, February 15 - 18, 2004 in Hamburg.

References

  • 1 Jin X Y, Gibson D G, Yacoub M H, Pepper J R. Perioperative assessment of aortic homograft, Toronto stentless valve, and stented valve in the aortic position.  Ann Thorac Surg. 1995;  60 S395-S401
  • 2 Konertz W. Stentless aortic xenograft heart valves.  Asian Cardiovasc Thorac Ann. 2003;  11 1-2
  • 3 Stacchino C, Bona G, Rinaldi S, Vallana F. Design and performance characteristics of the Pericarbon stentless valve.  J Heart Valve Dis. 1995;  4 S102-S105
  • 4 Jin X Y, Westaby S. Pericardial and porcine stentless aortic valves: Are they hemodynamically different?.  Ann Thorac Surg. 2001;  71 S311-S314
  • 5 Westaby S. Implant technique for the Sorin stentless pericardial valve.  Operat Tech Thorac Cardiovasc Surg. 2001;  6 101-115
  • 6 Calafiore A M, Teodori G, Mezzetti et A. al. Intermittent antegrade warm blood cardioplegia.  Ann Thorac Surg. 1995;  59 398-402
  • 7 Nashef S A, Roques F, Michel P, Gauducheau E, Lemeshow S, Salamon R. Risk factors and outcome in European cardiac surgery: analysis of the EuroSCORE multinational database of 19 030 patients.  Eur J Cardiothorac Surg. 1999;  15 816-823
  • 8 Bach D S, David T E, Yacoub M. et al . Hemodynamics and left ventricular mass regression following implantation of the Toronto SPV stentless porcine valve.  Am J Cardiol. 1998;  82 1214-1219
  • 9 Ennker J, Rosendahl U, Ennker I C, Bauer S, Florath I. Risk in elderly patients after stentless versus stented aortic valve surgery.  Asian Cardiovasc Thorac Ann. 2003;  11 37-41
  • 10 Westaby S, Horton M, Jin X Y. et al . Survival advantage of stentless aortic bioprostheses.  Ann Thorac Surg. 2000;  70 785-790
  • 11 Seguin J R, Grandmougin D, Folliguet T, Warembourg H, Laborde F, Chaptal P A. Long-term results with the Sorin Pericarbon valve in the aortic position: a multicenter study.  J Heart Valve Dis. 1998;  7 278-282
  • 12 Folliguet T A, Dibie A, Czitrom D, Le Bret E, Laborde F. Ten-years' clinical experience with the Sorin Pericarbon valve.  J Heart Valve Dis. 2000;  9 423-428
  • 13 Bonacchi M, Giunti G, Prifti E. et al. . Early postoperative outcome and hemodynamic performance of the Sorin Pericarbon stentless aortic valve.  J Heart Valve Dis. 2002;  11 703-709
  • 14 Jin X Y, Westaby S, Gibson D G, Pillai R, Taggart D P. Left ventricular remodelling and improvement in Freestyle stentless valve haemodynamics.  Eur J Cardiothorac Surg. 1997;  12 63-69
  • 15 Kirklin J K, Westaby S, Blackstone E H, Kirklin J W, Chenoweth D E, Pacifico A D. Complement and the damaging effects of cardiopulmonary bypass.  J Thorac Cardiovasc Surg. 1983;  86 845-857
  • 16 Kirklin J W, Barrat-Boyes B G. Cardiac Surgery. 2nd ed. New York, Edinburgh, London, Melbourne, Tokyo; Churchill Livingstone 1993: 129-166

1 Presented at the Satellite Symposium “Benefits of Bioprostheses” at the 4th joint meeting of the German, Austrian and Swiss Societies for Thoracic and Cardiovascular Surgery, February 15 - 18, 2004 in Hamburg.

M.D., PhD Sven Beholz

Department of Cardiovascular Surgery
Charité - University Medicine Berlin

Luisenstraße 65

10117 Berlin

Germany

Phone: + 4930450522196

Fax: + 49 3 04 50 52 29 21

Email: sven.beholz@charite.de