title: Time-related hemodynamic changes after aortic replacement with the freestyle stentless xenograft.
abstract: BACKGROUND
  The Freestyle valve is a porcine aortic root fixed with net zero pressure across the cusps and treated with the anticalcification agent alpha-aminooleic acid. We evaluated the hemodynamic function of this stentless valve.
  
  
  METHODS
  We implanted the valve into 80 consecutive patients scheduled to receive a bioprosthesis. Sixty-nine patients were more than 70 years old and 14 had calcified aortic sinuses. The "cylinder within a cylinder" implantation technique was used. Twenty-seven patients received coronary grafts, and 3 had mitral repair. All patients were studied echocardiographically during week 1 and 41 were studied at 6 months.
  
  
  RESULTS
  Median ischemic time for isolated aortic valve replacement was 44 minutes. There were four hospital deaths, none valve related. No patient had more than trivial aortic regurgitation. Mean systolic gradients for valve sizes 21 to 25 mm fell significantly with time (p < or = 0.05) due to remodeling of the porcine root and early regression of left ventricular hypertrophy. Late hemodynamic function was equivalent to an aortic homograft.
  
  
  CONCLUSIONS
  The Freestyle valve is easily implanted and has excellent hemodynamics. Transvalvular gradients decrease progressively.
authors.affiliation: Department of Cardiac Surgery, Oxford Heart Centre, John Radcliffe Hospital, England.
authors.forename: S
authors.initials: S
authors.lastname: Westaby
authors.forename: N
authors.initials: N
authors.lastname: Amarasena
authors.forename: V
authors.initials: V
authors.lastname: Long
authors.forename: A
authors.initials: A
authors.lastname: Prothero
authors.forename: G A
authors.initials: GA
authors.lastname: Amarasena
authors.forename: A P
authors.initials: AP
authors.lastname: Banning
authors.forename: R
authors.initials: R
authors.lastname: Pillai
authors.forename: O
authors.initials: O
authors.lastname: Ormerod
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001705:Bioprosthesis; D004452:Echocardiography; D005260:Female; D006350:Heart Valve Prosthesis; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D013997:Time Factors