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Open Access 01-12-2021 | Aortic Valve Replacement | Research article

Geometric changes in aortic root replacement using Freestyle prosthesis

Authors: Anja Osswald, Alina Zubarevich, Arian Arjomandi Rad, Robert Vardanyan, Konstantin Zhigalov, Daniel Wendt, Bastian Schmack, Ahmed Mashhour, Arjang Ruhparwar, Alexander Weymann

Published in: Journal of Cardiothoracic Surgery | Issue 1/2021

Abstract

Background

The Medtronic Freestyle prosthesis has proven to be a promising recourse for aortic root replacement in various indications. The present study aims to evaluate clinical outcomes and geometric changes of the aorta after Freestyle implantation.

Methods

Between October 2005 and November 2020, the computed tomography angiography (CTA) data of 32 patients were analyzed in a cohort of 68 patients that underwent aortic root replacement using Freestyle prosthesis. The minimum and maximum diameters and areas of the aortic annulus, aortic root, ascending aorta, and the proximal aortic arch were measured at a plane perpendicular to the long axis of the aorta using 3D multiplanar reconstruction in both the preoperative (n = 32) and postoperative (n = 10) CTAs. Moreover, volumetric changes of the aortic root and ascending aorta were quantified.

Results

Mean age was 64.6 ± 10.6 years. Indications for surgery using Freestyle prosthesis were combined aortic valve pathologies, aortic aneurysm or dissection, and endocarditis, with concomitant surgery occurring in 28 out of 32 patients. In-hospital mortality was 18.6%.

Preoperative diameter and area measurements of the aortic annulus strongly correlated with the implanted valve size (p < 0.001). Bicuspid valve was present in 28.1% of the patients. Diameter and areas of the aortic root decreased after freestyle implantation, resulting in a reduction of the aortic root volume (45.6 ± 26.3 cm³ to 18.7 ± 4.5 cm³, p = 0.029). Volume of the aortic root and the ascending aorta decreased from 137.3 ± 65.2 cm³ to 54.5 ± 21.1 cm³ after Freestyle implantation (p = 0.023).

Conclusion

Implantation of the Freestyle prosthesis presents excellent results in restoring the aortic geometry. Preoperative CTA measurements are beneficial to the surgical procedure and valve selection and therefore, if available, should be considered in pre-operative planning.

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Title: Geometric changes in aortic root replacement using Freestyle prosthesis
Authors: Anja Osswald
Alina Zubarevich
Arian Arjomandi Rad
Robert Vardanyan
Konstantin Zhigalov
Daniel Wendt
Bastian Schmack
Ahmed Mashhour
Arjang Ruhparwar
Alexander Weymann
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Aortic Valve Replacement
Computed Tomography
Computed Tomography
Endocarditis
CT Angiography
Aortic Valve Replacement
Aortic Valve Replacement
Aortic Dissection
Published in: Journal of Cardiothoracic Surgery / Issue 1/2021
Electronic ISSN: 1749-8090
DOI: https://doi.org/10.1186/s13019-021-01583-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Geometric changes in aortic root replacement using Freestyle prosthesis

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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