The Journal of Thoracic and Cardiovascular Surgery
Volume 130, Issue 5 , Pages 1265-1269, November 2005

Single–suture line placement of a pericardial stentless valve

  • Alberto Repossini, MD

      Affiliations

    • Cardiac Surgery, Cliniche Humanitas Gavazzeni, Bergamo, Italy
    • Corresponding Author InformationAddress for reprints: Alberto Repossini, MD, Cliniche Humanitas Gavazzeni, Via Mauro Gavazzeni No. 21, 24125 Bergamo, Italy
    • ,
  • Igor Kotelnikov, MD

      Affiliations

    • Cardiac Surgery, Cliniche Humanitas Gavazzeni, Bergamo, Italy
    • ,
  • Riad Bouchikhi, MD

      Affiliations

    • Cardiac Surgery, Cliniche Humanitas Gavazzeni, Bergamo, Italy
    • ,
  • Tiziano Torre, MD

      Affiliations

    • Cardiac Surgery, Cliniche Humanitas Gavazzeni, Bergamo, Italy
    • ,
  • Bruno Passaretti, MD

      Affiliations

    • Cardiac Surgery, Cliniche Humanitas Gavazzeni, Bergamo, Italy
    • ,
  • Oberdan Parodi, MD

      Affiliations

    • Institute of Clinical Physiology of the National Council of Research, Pisa, Italy.
    • ,
  • Vincenzo Arena, MD

      Affiliations

    • Cardiac Surgery, Cliniche Humanitas Gavazzeni, Bergamo, Italy

Received 17 December 2004; received in revised form 5 July 2005; accepted 19 July 2005.

Objective

Implantation of bioprostheses in the supra-annular position with the single suture line was first applied by O’Brien to porcine stentless valves. The aim of this study was to evaluate the clinical performance of the Pericarbon Freedom stentless bioprosthesis (Sorin Biomedica Cardio, Saluggia, Italy) implanted in supra-annular position with the single–suture line technique. The single-suture approach for the Pericarbon Freedom stentless bioprosthesis is obtained by trimming away all the extra tissue of the valve inflow side and scalloping the outflow side.

Methods

Between February 2002 and August 2004, a total of 65 consecutive patients at our institution (48% male, mean age 69 ± 12 years) underwent aortic valve replacement with Pericarbon Freedom stentless bioprostheses implanted with a single suture line. Most recurrent etiology was senile degeneration (80%). Pericarbon Freedom 25-mm and 27-mm valves were the most frequently implanted. Thirty patients had concomitant procedures (mainly coronary artery bypass grafting, 16 patients). Overall crossclamp time was 76 ± 21 minutes.

Results

All patients survived intervention. One patient died early of multiorgan failure (postoperative day 16). There were 4 early non–valve-related complications and no late complications at a mean follow-up of 491 ± 270 days. Four patients showed trivial central prosthetic regurgitation at intraoperative transesophageal echocardiography; among these cases, only 1 was confirmed at 6-month transthoracic echocardiography. At postoperative echocardiographic assessment, mean pressure gradient for the 25- through 29-mm size group was 10.2 ± 7.1 mm Hg, and peak pressure gradient was 18.1 ± 12.3 mm Hg.

Conclusion

Our initial experience combined a well-established supra-annular implantation technique with the Pericarbon Freedom stentless bioprosthesis, a latest-generation pericardial stentless valve. The combination showed excellent results in terms of safety and reliability, although this technique required adequate experience. Clinical outcomes are similar to those obtained with other techniques, with satisfactory hemodynamic performance.

Abbreviations and Acronyms:  PF, Pericarbon Freedom

CTSNet classification:  18 , 35

 

PII: S0022-5223(05)01283-3

doi:10.1016/j.jtcvs.2005.07.045

The Journal of Thoracic and Cardiovascular Surgery
Volume 130, Issue 5 , Pages 1265-1269, November 2005

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