Clinical Experience With the Freedom SOLO Stentless Aortic Valve in 277 Consecutive Patients

Thalmann, Markus; Kaiblinger, Josef; Krausler, R.; Pisarik, Harald; Veit, Franz; Taheri, Niuscha; Kornigg, Karin; Dinges, Christian; Grabenwöger, Martin; Stanger, Olaf

doi:10.1016/j.athoracsur.2014.05.089

Cited by 19 publications

(16 citation statements)

References 18 publications

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“…Low rates, of 0%-3.0%, of permanent pacemaker (PM) implantation have been reported for patients receiving the FS. 32,33,37,38 This data is in line with the requirement for permanent PM implantation after isolated AVR with stented prostheses in 7.0% of patients, in a recent meta-analysis including 2,557 patients for best evidence analyses. 39 The low rate of permanent PM (Table 2) in patients receiving the FS could be explained by the implantation technique, which strictly follows supra-annular positioning and therefore avoids trauma to the AV node or His bundle in the region of the membranous septum and right trigonum, beneath the NC to right coronary cusp commissure.…”

Section: Requirement For Permanent Pacemakersupporting

confidence: 52%

“…43 Postoperative regression of LVH, eg, decreases of LV end-diastolic diameter, LV end-systolic diameter, and interventricular septum thickness, following AVR with FS have been reported after 1 year. 33,37 Compared with stented bioprostheses or mechanical valves, a more rapid and more complete resolution of LVH in relation to remodeling and improved function have been reported. 44,45 In general, differences in LVMR between stented and stentless valves persisted until 1 year postsurgery, but not longer.…”

Section: Mass Regressionmentioning

confidence: 99%

“…Furthermore, no impairment in platelet-fibrinogen interactions for thrombus formation and no change in postoperative platelet function have been observed. 62 Causal hemodynamic stress appears highly unlikely given the large EOA and low gradients of a correctly sized FS, 37 with performances similar to native aortic valves under rest and stress conditions. 63 At this point, the precise mechanism of FS-dependent thrombocytopenia remains to be identified.…”

Section: Transient Postoperative Thrombocytopeniamentioning

confidence: 99%

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The Freedom SOLO bovine pericardial stentless valve

Stanger¹,

Tevaearai²,

Carrel³

2014

RRCC

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Abstract:The third-generation bovine pericardium Freedom SOLO (FS) stentless valve emerged in 2004 as a modified version of the Pericarbon Freedom stentless valve and as a very attractive alternative to stented bioprostheses. The design, choice of tissue, and anticalcification treatment fulfill most, if not all, requirements for an ideal valve substitute. The FS combines the singlesuture, subcoronary implantation technique with the latest-generation bovine pericardial tissue and novel anticalcification treatment. The design allows imitation of the native healthy valve through unrestricted adaption to the patient's anatomy, reproducing a normal valve/root complex. However, despite hemodynamic performance superior to stented valves, we are approaching a critical observation period as superior durability, freedom from structural valve deterioration, and nonstructural failure has not been proven as expected. However, optimal performance and freedom from structural valve deterioration depend on correct sizing and perfect symmetric implantation, to ensure low leaflet stress. Any malpositioning can lead to tissue fatigue over time. Furthermore, the potential for better outcomes depends on optimal patient selection and observance of the limitations for the use of stentless valves, particularly for the FS. Clearly, stentless valve implantation techniques are less reproducible and standardized, and require surgeondependent experience and skill. Regardless of whether or not stentless valve durability surpasses third-generation stented bioprostheses, they will continue to play a role in the surgical repertoire. This review intends to help practitioners avoid pitfalls, observe limitations, and improve patient selection for optimal long-term outcome with the attractive FS stentless valve.

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Section: Requirement For Permanent Pacemakersupporting

confidence: 52%

Section: Mass Regressionmentioning

confidence: 99%

Section: Transient Postoperative Thrombocytopeniamentioning

confidence: 99%

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The Freedom SOLO bovine pericardial stentless valve

Stanger¹,

Tevaearai²,

Carrel³

2014

RRCC

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“…In five studies (n ¼ 441), measurement with transthoracic echocardiography showed left ventricular (LV) mass decreased 19% to 32% up to 2 years of follow-up compared with preoperative measurements (p < 0.05) [13][14][15][16]18]. In six studies (n ¼ 745), LV end-diastolic diameters decreased 3% to 10% and LV end-systolic diameters decreased 6% to 12% during 1 to 2 years of follow-up [15,16,[18][19][20][21]. Only one study showed a high 5% increase in LV end-diastolic diameters and a 4% increase in LV end-systolic diameters during 3 months of follow-up [17].…”

Section: Clinical Outcomesmentioning

confidence: 98%

Aortic Valve Replacement With the Stentless Freedom SOLO Bioprosthesis: A Systematic Review

Wollersheim¹,

Li²,

Bouma³

et al. 2015

The Annals of Thoracic Surgery

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“…With their thin-walled architecture, larger prostheses can be implanted, and PPM can be avoided more easily compared with traditional stented bioprostheses. 4,5 We congratulate Sénage and coworkers for their important contribution to this topic.…”

Section: To the Editormentioning

confidence: 99%