Westaby S, Amarasena N, Long V, Prothero A, Amarasena G A, Banning A P, Pillai R, Ormerod O
Department of Cardiac Surgery, Oxford Heart Centre, John Radcliffe Hospital, England.
Ann Thorac Surg. 1995 Dec;60(6):1633-8; discussion 1639. doi: 10.1016/0003-4975(95)00639-7.
The Freestyle valve is a porcine aortic root fixed with net zero pressure across the cusps and treated with the anticalcification agent alpha-aminooleic acid. We evaluated the hemodynamic function of this stentless valve.
We implanted the valve into 80 consecutive patients scheduled to receive a bioprosthesis. Sixty-nine patients were more than 70 years old and 14 had calcified aortic sinuses. The "cylinder within a cylinder" implantation technique was used. Twenty-seven patients received coronary grafts, and 3 had mitral repair. All patients were studied echocardiographically during week 1 and 41 were studied at 6 months.
Median ischemic time for isolated aortic valve replacement was 44 minutes. There were four hospital deaths, none valve related. No patient had more than trivial aortic regurgitation. Mean systolic gradients for valve sizes 21 to 25 mm fell significantly with time (p < or = 0.05) due to remodeling of the porcine root and early regression of left ventricular hypertrophy. Late hemodynamic function was equivalent to an aortic homograft.
The Freestyle valve is easily implanted and has excellent hemodynamics. Transvalvular gradients decrease progressively.
Freestyle瓣膜是一种猪主动脉根部瓣膜，其瓣叶跨瓣压力为零，并经抗钙化剂α-氨基油酸处理。我们评估了这种无支架瓣膜的血流动力学功能。
我们将该瓣膜植入80例计划接受生物假体瓣膜置换的连续患者体内。69例患者年龄超过70岁，14例有钙化主动脉窦。采用“筒中筒”植入技术。27例患者接受了冠状动脉移植，3例进行了二尖瓣修复。所有患者在第1周接受了超声心动图检查，41例患者在6个月时接受了检查。
单纯主动脉瓣置换的中位缺血时间为44分钟。有4例医院死亡病例，均与瓣膜无关。没有患者出现超过轻度的主动脉瓣反流。由于猪主动脉根部重塑和左心室肥厚早期消退，21至25毫米瓣膜尺寸的平均收缩期梯度随时间显著下降（p≤0.05）。晚期血流动力学功能与主动脉同种异体移植物相当。
Freestyle瓣膜易于植入，血流动力学良好。跨瓣梯度逐渐降低。
