نبذة مختصرة : Publisher Copyright: © 2021 The Authors ; Objectives: Our objective was to examine intermediate-term survival and reinterventions in unselected patients, stratified according to indication, who received a Freestyle (Medtronic Inc, Minneapolis, Minn) bioprosthesis as a full aortic root replacement. Methods: Data from medical records were retrospectively collected for patients who had aortic root replacement using Freestyle bioprostheses between 1999 and 2018 at 6 North-Atlantic centers. Survival status was extracted from national registries and results stratified according to indication for surgery. Results: We included 1030 implantations in 1008 patients with elective indications for surgery: aneurysm (39.8%), small root (8.3%), and other (13.8%), and urgent/emergent indications: endocarditis (26.7%) and Stanford type A aortic dissection (11.4%). Across indications, 46.3% were nonelective cases and 34.0% were reoperations. Median age was 66.0 (interquartile range, 58.0-71.8) years and median follow-up was 5.0 (interquartile range, 2.6-7.9) years. Thirty-day mortality varied from 2.9% to 27.4% depending on indication. Intermediate survival for 90-day survivors with elective indications were not different from the general population standardized for age and sex (P = .95, 83, and .16 for aneurysms, small roots, and other, respectively). In contrast, patients with endocarditis and type A dissection had excess mortality (P < .001). Freedom from valve reinterventions was 95.0% and 94.4% at 5 and 8 years, respectively. In all, 52 patients (5.2%) underwent reinterventions, most because of endocarditis. Conclusions: At intermediate term follow-up this retrospective study provides further support for the use of the Freestyle bioprosthesis in the real-world setting of diverse, complex, and often high-risk aortic root replacement and suggests that outcome is determined by patient and disease, rather than by prosthesis, characteristics. ; Peer reviewed
Relation: Journal of Thoracic and Cardiovascular Surgery; 164(6); http://www.scopus.com/inward/record.url?scp=85113240826&partnerID=8YFLogxK; Dagnegård , H H , Bekke , K , Kolseth , S M , Glaser , N , Wallén , C , El-Hamamsy , I , Víðisson , K O , Lie , A S , Valentin , J B , Sartipy , U , Haaverstad , R , Vanky , F , Lefebvre , L , Guðbjartsson , T , Johnsen , S P , Søndergaard , L , Thyregod , G H , Lund , J T , Ihlemann , N & Smerup , M H 2021 , ' Survival after aortic root replacement with a stentless xenograft is determined by patient characteristics ' , Journal of Thoracic and Cardiovascular Surgery , vol. 164 , no. 6 , pp. 1712-1724 . https://doi.org/10.1016/j.jtcvs.2021.07.011; 445c08c4-5346-4f4a-9684-51c336577602; 85113240826; unpaywall: 10.1016/j.jtcvs.2021.07.011; https://hdl.handle.net/20.500.11815/4099
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