Long Term Outcomes Following Freestyle Stentless Aortic Bioprosthesis Implantation: An Australian Experience

Heart Lung Circ. 2016 Jan;25(1):82-8. doi: 10.1016/j.hlc.2015.05.011. Epub 2015 Jun 10.

Abstract

Background: The Freestyle stentless bioprosthesis (FSB) has been demonstrated to be a durable prosthesis in the aortic position. We present data following Freestyle implantation for up to 10 years post-operatively and compare this with previously published results.

Methods: A retrospective cohort analysis of 237 patients following FSB implantation occurred at five Australian hospitals. Follow-up data included clinical and echocardiographic outcomes.

Results: The cohort was 81.4% male with age 63.2±13.0 years and was followed for a mean of 2.4±2.3 years (range 0-10.9 years, total 569 patient-years). The FSB was implanted as a full aortic root replacement in 87.8% patients. The 30-day all cause mortality was 4.2% (2.0% for elective surgery). Cumulative survival at one, five and 10 years was 91.7±1.9%, 82.8±3.8% and 56.5±10.5%, respectively. Freedom from re-intervention at one, five and 10 years was 99.5±0.5%, 91.6±3.7% and 72.3±10.5%, respectively. At latest echocardiographic review (mean 2.3±2.1 years post-operatively), 92.6% had trivial or no aortic regurgitation. Predictors of post-operative mortality included active endocarditis, acute aortic dissection and peripheral vascular disease.

Conclusions: We report acceptable short and long term outcomes following FSB implantation in a cohort of comparatively younger patients with thoracic aortic disease. The durability of this bioprosthesis in the younger population remains to be confirmed.

Keywords: Aorta; Aortic Aneurysm; Aortic valve; Bioprosthesis; Heart valve prosthesis; Thoracic.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aortic Diseases* / diagnostic imaging
  • Aortic Diseases* / mortality
  • Aortic Diseases* / surgery
  • Bioprosthesis*
  • Blood Vessel Prosthesis*
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Survival Rate
  • Ultrasonography