title: Operative technique and early hemodynamic results with the Freedom Solo valve.
abstract: OBJECTIVE
  Stentless aortic valve prostheses usually require two separate suture lines. The Freedom Solo valve (Sorin Group, Saluggia, Italy), by using a minimized implantation technique, requires only a single running suture line of 4-0 polypropylene. Herein are reported the surgical experience and early hemodynamic results obtained with this new valve.
  
  
  METHODS
  Following annular decalcification, the Freedom Solo prosthesis was implanted in the supraannular aortic position in the sinuses of Valsalva of 82 patients (52 females, 30 males; mean age 76.6 +/- 7.0 years). Echocardiography was performed to monitor gradients and regurgitation.
  
  
  RESULTS
  The logistic EuroSCORE was 12.8 +/- 9.9. Isolated aortic valve replacement was performed in 48 patients; concomitant procedures included coronary artery bypass grafting, mitral procedures, subvalvular myectomy, and atrial ablation. The mean valve size implanted was 26.4 +/- 2.1 mm, and cross-clamp time was 39.0 +/- 7.0 min in primary isolated valve replacement. Non-valve-related 30-day mortality was 3.6%. At discharge, hemodynamic parameters were favorable, with low peak (16.2 +/- 8.0 mmHg) and mean (8.3 +/- 4.5 mmHg) gradients, and without paravalvular leakage and only minimal regurgitation (grade < I degrees) in 10 patients.
  
  
  CONCLUSIONS
  Supraannular implantation of the Freedom Solo stentless valve is safe and reliable, using a single suture line. The valve provides excellent hemodynamics at hospital discharge, without paravalvular leakage. The reduced cross-clamp time represents an attractive surgical alternative in elderly patients.
authors.affiliation: Department of Cardiovascular Surgery, Charité - University Medicine Berlin, Berlin, Germany. sven.beholz@charite.de
authors.forename: Sven
authors.initials: S
authors.lastname: Beholz
authors.forename: Benjamin
authors.initials: B
authors.lastname: Claus
authors.forename: Simon
authors.initials: S
authors.lastname: Dushe
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Konertz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004562:Electrocardiography; D004867:Equipment Design; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation* / Q000379:methods*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013537:Sutures