title: Sutureless 3F Enable Valve Replacement for Pure Aortic Regurgitation.
abstract: OBJECTIVE
  We present our experience in the use of the sutureless valve in patients undergoing aortic valve replacement for pure aortic regurgitation.
  
  
  METHODS
  Out of 167 patients who underwent sutureless aortic valve implantation with a Medtronic 3f Enable prosthesis in our unit between March 2011 and February 2014, 12 (7.1%) received a sutureless valve for pure aortic regurgitation.
  
  
  RESULTS
  Mean age, logistic EuroSCORE, and left ventricular ejection fraction were 72 ± 5 years, 6.3 ± 2.9%, and 52.5 ± 15.3%, respectively. The sutureless valve could be successfully implanted in all cases; nine patients had a full sternotomy (associated coronary artery bypass graft in four cases and associated mitral surgery in five), one patient had a ministernotomy, and two had a thoracoscopic approach. Average cross-clamping and cardiopulmonary bypass times were 90 ± 30 and 127 ± 51 minutes, respectively. At the outpatient echocardiography, average mean gradient was 10.54 ± 4.99 mmHg and a grade I-II paravalvular leakage (PVL) was detected in the first patient of the cohort (ministernotomy approach). At a mean follow-up of 11.1 ± 5.5 months, average mean gradient was 9.75 ± 2.87 mmHg, no new PVL was detected, and the known PVL was stable. No pacemaker implantation was required.
  
  
  CONCLUSIONS
  Implantation of the 3f Enable sutureless valve is technically possible with pure aortic regurgitation in selected patients. Multicenter investigations are necessary to assess the mid-term benefits of such a device in this subset of patients.
authors.affiliation: Cardiovascular Surgery Unit, St-Etienne University Hospital, St-Etienne, France.
authors.forename: Marco
authors.initials: M
authors.lastname: Vola
authors.affiliation: Cardiovascular Surgery Unit, St-Etienne University Hospital, St-Etienne, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Fuzellier
authors.affiliation: Cardiovascular Surgery Unit, St-Etienne University Hospital, St-Etienne, France.
authors.forename: Amedeo
authors.initials: A
authors.lastname: Anselmi
authors.affiliation: Cardiovascular Surgery Unit, St-Etienne University Hospital, St-Etienne, France.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Campisi
authors.affiliation: Cardiology Unit, St-Etienne University Hospital, St-Etienne, France.
authors.forename: Benjamain
authors.initials: B
authors.lastname: Haber
authors.affiliation: Cardiology Unit, St-Etienne University Hospital, St-Etienne, France.
authors.forename: Karl
authors.initials: K
authors.lastname: Isaaz
authors.affiliation: Cardiology Unit, St-Etienne University Hospital, St-Etienne, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Gerbay
authors.affiliation: Cardiovascular Surgery Unit, St-Etienne University Hospital, St-Etienne, France.
authors.forename: Vito Giovanni
authors.initials: VG
authors.lastname: Ruggieri
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000503:physiopathology / Q000601:surgery*; D002315:Cardiopulmonary Bypass; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D056346:Sternotomy; D013318:Stroke Volume; D013906:Thoracoscopy; D013997:Time Factors; D016896:Treatment Outcome