ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Sabahattin GÖKSEL, Kamil GÖL, Zafer İŞCAN, Ülkü YILDIZ, Mehmet Ali ÖZATİK, Binali MAVİTAŞ, Oğuz TAŞDEMİR
Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi Kalp Damar Cerrahisi Kliniği, ANKARA

To evaluate the early and mid-term results of aortic valve replacements (AVR) in an older patient group with a stentless valve "Medtronic Freestyle" which is pretreated with an anti-mineralizing agent, alpha-amino-oleic acid. Methods:

AVR was performed with Medtronic Freestyle bioprosthesis to 40 patients with a mean age of 61.6 ± 6.5 years (55-71).Thirteen (35%) of the patients were female. Mean preoperative functional capacity according to NYHA was 2.9. Five patients had diabetes and 3 patients were hypertensive. Mean preoperative systolic aortic gradient was 78 ± 29 mmHg in cases that were operated for aortic stenosis. Mean cross-clamp duration and cardiopulmonary bypass time were 79 ± 12 minutes, and 110 ± 27 minutes respectively. Results:

One patient died in the early postoperative period (2.5%). Total follow-up of the patients those were discharged were 60.1 years. Mean follow-up was 18.9 ± 12.3 months. Two late deaths occurred during the follow up due to non-cardiac causes. Actuarial survival rate for 12 months was calculated to be 94.9% and 92.2% for 18 months. Left ventricular mass index decreased significantly (p =0.02). During the follow-up, no valve related complications such as thromboemboli, prosthetic valve endocarditis or paravalvular leak were observed. Structural valve dysfunction was not seen and no reoperations were needed. Conclusion:

Even though long term durabilities need to be proven, stentless bioprosthesis with their superior hemodynamic performance, advantages for the regression of left ventricular hypertrophy and with minimal valve related complications in the mid term follow-up, are better choices compared to other valves in the elderly.

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