Single-center experience using the Freedom SOLO aortic bioprosthesis.

OBJECTIVE: This study reviews a single institution experience with the Freedom SOLO (Sorin Group, Saluggia, Italy) aortic bioprosthesis. METHODS: Between October 2006 and February 2010, 128 patients (64 men, 64 women; mean age, 75.8 ± 5.1 years) underwent aortic valve replacement using the Freedom SOLO stentless aortic valve. The follow-up time was 36.7 ± 1.2 months and 100% complete. RESULTS: Concomitant procedures were performed in 77 patients (60%). The mean standard European System for Cardiac Operative Risk Evaluation was 9 ± 2.7. Grade 3 aortic stenosis was present in 73% of patients, mixed aortic stenosis and regurgitation were present in 40% of patients, and mitral regurgitation was present in 46% of patients. The mean crossclamp time was 53 ± 12 minutes for isolated Freedom SOLO aortic valve implantation and 80 ± 28 minutes for concomitant procedures, and the mean cardiopulmonary bypass time was 103 ± 31 minutes. The mean implanted valve size was 22.6 ± 1.4 mm. The mean intensive care unit and hospital stays were 2.4 ± 1.1 days and 8.8 ± 2.6 days, respectively. Three patients underwent reoperation for bleeding. The 15-day, 30-day, and perioperative mortality were all 4.6%. The 36-month survival was 95.4% ± 1.6% for the cohort with a low European System for Cardiac Operative Risk Evaluation (<9) and 88.6% ± 1.7% for the cohort with a high European System for Cardiac Operative Risk Evaluation (>9). Echocardiographic data preoperatively, immediately postoperatively, and at 3, 6, and 12 months postoperatively showed peak transvalvular gradients of 75 ± 23, 17 ± 6, 18 ± 6.5, 16 ± 6, and 16 ± 9 mm Hg, respectively (P < .001), and a mean left ventricular end-diastolic diameter of 51 ± 7, 50 ± 6, 48 ± 8, 47 ± 6, and 46.5 ± 7.5 mm, respectively (P < .05). There were only 3 cases of early mild aortic regurgitation (grade 1), which remained stable at 12 months. CONCLUSIONS: The Freedom SOLO stentless aortic valve has excellent early and intermediate-term results.

Deep hypothermic arrest for aortic valve replacement in case of porcelain aorta.

A 71-year-old man presented with severe aortic stenosis and a heavily calcified aorta. Cardiopulmonary bypass was established with arterial cannula via the distal aortic arch. Deep hypothermic circulatory arrest and retrograde cerebral perfusion were initiated for excision of the ascending aorta. A tube graft was anastomosed to the proximal aortic arch, circulation was reestablished, the aortic valve was replaced with a bioprosthesis, and proximal anastomosis to the sinotubular junction was preformed.