Abstract 16922: Accelerated Degeneration and Late Detachment of the Freestyle Aortic Root in Young Adults

• DOI: 10.1161/circ.138.suppl_1.16922
• Publication Date: 2024-04-23T13:41:58Z
• Authors: Hatem Hosny; Ahmed Eldowaik; Amir Samaan; Peter P Selwanos; Soha Romeih; Mohamed Hassan; Mohamed El-Khatib; Muhammed Hebala; Ismail Bouhout; Ismail El-Hamamsy; Ahmed Afifi; Magdi Yacoub
• Keywords: Degeneration (medical)

Introduction: The ideal valve substitute for the aortic in young adults is yet to be identified. Freestyle stentless root seems a viable candidate, but there not enough data about how it behaves patients. Methods: This study reports mid-term clinical outcome after total replacement with porcine (Medtronic Freestyle) patients younger than 50 years, single center, during period from 2009 2017. Results: 173 were enrolled this study. median age at operation was 32 years (6-50). 56% males. 89 (51%) had rheumatic heart disease, while 25 (14%) bicuspid valve. 10 (6%) aneurysm. size (21-29). 43 (25%) concomitant procedure operation, mostly mitral surgery. bypass time 180 minutes (82-380). follow-up 41 months (2-101). In-hospital mortality 1.2%, late 4%. Valve degeneration included virtual disappearance of walls sinuses (encountered 2 9 and 3 years) detachment ring (in 5 years), resulting false aneurysms (Figure 1a). Alarmingly, who developed discovered by MSCT routine follow-up, one them normal earlier, 1b). re-operation aneurysm, no early mortality. One patient presented cardiogenic shock caused severe stenosis due calcification 1c) died re-operation. Structural deterioration (defined as mean gradient > 20 mmHg or regurgitation 2/4) 21 ± 8% years. Freedom reintervention 98 3% Conclusions: Although offers excellent hemodynamics, risk development found major concerns. implantation should used caution. We recommend annual screening those contrast-enhanced imaging detection such complications.