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

详细信息    查看全文

• 作者：Andrew G Sherrah ; MBBS^a ; ^b ; Richmond W Jeremy ; PhD FRACP^a ; ^b ; ^c ; Rajesh Puranik ; PhD FRACP^a ; ^c ; Paul G Bannon ; PhD FRACS^a ; ^b ; ^d ; ^e ; P Nicholas Hendel ; FRACS^b ; ^d ; Matthew S Bayfield ; FRACS^b ; ^d ; Michael K Wilson ; FRACS^b ; ^d ; ^f ; Peter W Brady ; FRACS^g ; David Marshman ; FRACS^g ; Manu N Mathur ; FRACS^g ; R John Brereton ; FRACS^g ; James R Edwards ; FRACS^h ; Robert G Stuklis ; FRACS^h ; Michael Worthington ; FRACS^h ; Michael P Vallely ; PhD FRACS^a ; ^b ; ^d ; ^f ; ^{michael.vallely@sydneyheartandlung.com.au" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Aortic valve ; Heart valve prosthesis ; Bioprosthesis ; Aorta ; Thoracic ; Aortic Aneurysm
• 刊名：Heart, Lung and Circulation
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：25
• 期：1
• 页码：82-88
• 全文大小：618 K

文摘

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.