Da Col Uberto, Di Bella Isidoro, Bardelli Giuliana, Ramoni Enrico, Affronti Alessandro, Vidili Angela, Ragni Temistocle
Department of Cardiac Surgery, S. Maria della Misericordia Hospital, Perugia, Italy.
J Heart Valve Dis. 2007 Sep;16(5):546-50.
The new Sorin Freedom SOLO pericardial stentless valve is designed for supra-annular implantation, and requires only one running suture. It can be implanted with a short cross-clamp time, and is designed to offer the same hemodynamic advantages of other stentless valves. The study aim was to evaluate the prospective postoperative and two-month follow up hemodynamic performance of this bioprosthesis.
Thirty patients (13 males, 17 females; mean age 75.6 +/- 6.21 years) with severe aortic stenosis underwent valve replacement with the Sorin Freedom SOLO stentless valve. All patients underwent transthoracic echocardiography before surgery, before hospital discharge, and at two months' follow up. The peak and mean transprosthetic gradients, telediastolic and telesystolic diameters, septal and posterior wall thicknesses, total and indexed ventricular mass volume and left ventricular ejection fraction were evaluated.
Both, the transprosthetic peak gradient and mean gradient decreased significantly during the first two months (p < 0.05 and p < 0.001, respectively). The telediastolic diameter was significantly reduced between preoperative evaluation and follow up (p < 0.05). The interventricular septum thickness was decreased significantly after two months (p <0.001), as was the posterior wall thickness, albeit to a lesser degree (p < 0.05). Both, total and indexed ventricular mass volume showed a significant regression at the two months follow up (p < 0.001).
The Sorin Freedom SOLO stentless valve shows good hemodynamic performance, with an early and highly progressive left ventricular remod eling. If these data are confirmed in future studies, the SOLO prosthesis might represent a safe alternative to the use of conventional stentless valves.
新型索林自由SOLO心包无支架瓣膜设计用于瓣环上植入,仅需一根连续缝合线。它能在短体外循环时间下植入,旨在提供与其他无支架瓣膜相同的血流动力学优势。本研究目的是评估该生物假体术后及术后两个月随访时的血流动力学性能。
30例(13例男性,17例女性;平均年龄75.6±6.21岁)重度主动脉瓣狭窄患者接受了索林自由SOLO无支架瓣膜置换术。所有患者在手术前、出院前及术后两个月随访时均接受经胸超声心动图检查。评估跨瓣峰值梯度和平均梯度、舒张末期和收缩末期直径、室间隔和后壁厚度、全心和指数化心室质量体积以及左心室射血分数。
跨瓣峰值梯度和平均梯度在术后前两个月均显著降低(分别为p<0.05和p<0.001)。舒张末期直径在术前评估和随访之间显著减小(p<0.05)。两个月后室间隔厚度显著降低(p<0.001),后壁厚度也降低,尽管程度较小(p<0.05)。全心和指数化心室质量体积在术后两个月随访时均显著减小(p<0.001)。
索林自由SOLO无支架瓣膜显示出良好的血流动力学性能,伴有早期且高度进展性的左心室重构。如果这些数据在未来研究中得到证实,SOLO假体可能是传统无支架瓣膜的一种安全替代方案。