PMID- 14667607
OWN - NLM
STAT- MEDLINE
DCOM- 20040116
LR  - 20190628
IS  - 0003-4975 (Print)
IS  - 0003-4975 (Linking)
VI  - 76
IP  - 6
DP  - 2003 Dec
TI  - Medtronic freestyle valves in right ventricular outflow tract reconstruction.
PG  - 1896-900
AB  - BACKGROUND: Various pulmonary valve substitutes, with their inherent limitations, 
      have been used in children and young adults. We chose the Medtronic Freestyle 
      (Medtronics, Minneapolis, MN) valve because of its excellent hemodynamics, known 
      durability in adults, and design features that allow modifications during 
      implantation. METHODS: Over a 3 1/2 year period the Freestyle valve was implanted 
      in 47 patients age 2 to 58 years (mean 14.2, median 12.0) in the pulmonary 
      position. All patients had pulmonic stenosis and(or) insufficiency from previous 
      operations for tetralogy (27), pulmonary atresia (6), truncus (4), or other 
      diagnosis (10). The indication for surgery was pure pulmonary insufficiency in 11 
      patients, pulmonic stenosis in 3, and mixed stenosis and insufficiency in 33. 
      Root replacement technique was used with additional enlargement of the pulmonary 
      artery branches in 10 patients. RESULTS: Intraoperatively, one patient sustained 
      a right ventricle tear and one a circumflex coronary artery injury during the 
      dissection. There was one postoperative death. Two patients developed late 
      subvalvular pannus formation, one of whom required reoperation. One patient was 
      found to have an echo gradient of 95 mm Hg due to decreased leaflet motion and 
      underwent cardiac catheterization at which the peak systolic gradient was 
      determined to be 50 mm Hg. He has not required reintervention during his 3 1/2 
      years of follow-up. The remaining 43 patients have minimal gradients or 
      insufficiency. All surviving patients are in New York Heart Association (NYHA) 
      Class I. CONCLUSIONS: The Medtronic Freestyle valve is an attractive alternative 
      for RVOT (right ventricular outflow tract) reconstruction in children. It is 
      readily available, versatile, and has excellent hemodynamic characteristics. 
      Although long term follow-up is not yet available, longevity of this prosthesis, 
      and freedom from complications, will hopefully be superior to valves with stents.
FAU - Hartz, Renee S
AU  - Hartz RS
AD  - Department of Surgery and Pediatrics, Tulane University Medical Center, New 
      Orleans, Louisiana, USA.
FAU - Deleon, Serafin Y
AU  - Deleon SY
FAU - Lane, Jason
AU  - Lane J
FAU - Dorotan, Jamie
AU  - Dorotan J
FAU - Joyce, James
AU  - Joyce J
FAU - Urbina, Elaine
AU  - Urbina E
FAU - Ross-Ascuitto, Nancy
AU  - Ross-Ascuitto N
FAU - Ascuitto, Robert
AU  - Ascuitto R
LA  - eng
PT  - Journal Article
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
SB  - IM
CIN - Ann Thorac Surg. 2005 Jun;79(6):2202-3; author reply 2203. PMID: 15919359
MH  - Adolescent
MH  - Adult
MH  - Aortic Valve
MH  - *Bioprosthesis
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - *Heart Valve Prosthesis
MH  - *Heart Valve Prosthesis Implantation
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications
MH  - Pulmonary Artery/surgery
MH  - Pulmonary Valve/surgery
MH  - Ventricular Outflow Obstruction/*surgery
EDAT- 2003/12/12 05:00
MHDA- 2004/01/17 05:00
CRDT- 2003/12/12 05:00
PHST- 2003/12/12 05:00 [pubmed]
PHST- 2004/01/17 05:00 [medline]
PHST- 2003/12/12 05:00 [entrez]
AID - S0003497503013018 [pii]
AID - 10.1016/s0003-4975(03)01301-8 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 2003 Dec;76(6):1896-900. doi: 10.1016/s0003-4975(03)01301-8.