Aortic valve replacement with the Sorin Pericarbon Freedom stentless prosthesis: 7 years{'} experience in 130 patients

Objectives: Aortic stentless pericardial valves were introduced into clinical practice to combine properties of both stentless and pericardial prostheses. The aim of this single-center retrospective study was to assess midterm clinical and hemodynamic results of aortic valve replacement with the Sorin Pericarbon Freedom stentless bioprosthesis. Methods: From July 1999 through November 2005, 130 consecutive patients (73 [56.1%] male patients) underwent aortic valve replacement with the Sorin Pericarbon Freedom bioprosthesis at our institution. Mean age was 76 ± 5 years (range, 42-86 years), and associated procedures were performed in 50 (38.4%) patients; of these, 41 were coronary artery bypass grafts. Surgical intervention under urgent/emergency conditions and reoperations were performed in 18 (13.8%) and 7 (5.3%) patients, respectively. Mean crossclamp and cardiopulmonary bypass times were 82 ± 24 and 125 ± 40 minutes, respectively. All patients underwent clinical and echocardiographic follow-up (100% complete), and the total cumulative follow-up was 324 patient/years (mean, 2.5 ± 1.8; range, 6 months-7 years). Results: Overall hospital mortality was 8.4%. Overall patient survival was 63% ± 6% and 50% ± 10% at 5 and 7 years, respectively. Late deaths occurred in 23 patients, and 6 of them were valve related (1.8% patient/years). Freedom from valve-related death and reoperation was 91% ± 4% and 94% ± 4%, respectively, at 7 years. No structural valve deterioration was observed. Endocarditis, thromboembolism, and hemorrhagic complications occurred in 2 (0.6% patient/years), 1 (0.3% patient/years), and 1 (0.3% patient/years) patients, respectively. Mean transprosthetic gradients for valve sizes 23, 25, and 27 were 12.1 ± 3.8, 10.8 ± 3.8, and 9 ± 3.1 mm Hg, respectively. Conclusions: The Sorin Pericarbon Freedom stentless bioprosthesis provides good early and midterm results in terms of hemodynamic performance, survival, and freedom from valve-related complications. © 2007 The American Association for Thoracic Surgery.