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

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.

Aortic valve replacement - stentless biological valve - implantation technique - postoperative hemodynamics

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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.