Stentless bioprostheses: a versatile and durable solution in extensive XXXX   .

@entity1 @entity886 @entity337 @entity340 @entity884
OBJECTIVES: @entity884 of the aortic valve with local aortic root destruction requires radical resection of infected tissues and subsequent reconstruction of periannular structures and the left ventricular outflow tract (LVOT). Homografts or stentless bioprostheses are recommended for use in this specific @entity1 group. The Freestyle stentless bioprosthesis is a porcine aortic root prosthesis, which approaches the surgical versatility of the homograft, but has the advantage of ready availability and uniform quality. We assessed clinical and echocardiographic outcome following the use of this prosthesis in extensive @entity886 . METHODS: Between June 2000 and December 2014, 55 Freestyle prostheses were implanted for @entity886 involving the root in 54 @entity1 (74% male). The mean age at operation was 61    13 years. The mean EuroSCORE II was 20.1    13.5. Twenty-nine (54%) @entity1 had @entity340 . The median follow-up time after surgery was 3.5 years, ranging from 0 to 15 years. RESULTS: Early and late mortality were 11% (6 @entity1 ) and 14% (7 @entity1 ), respectively. Estimated overall survival at 1 and 5 years was 83 and 70%, respectively. There was no survival difference between @entity1 with native or @entity340 . One @entity1 underwent reoperation for recurrent @entity884 2.3 years after the initial procedure. No other prosthesis failure occurred. At a median follow-up of 3.3 years, mean gradient over the prosthesis was 4.3    2.3 mmHg. No @entity1 had more than mild @entity337 . CONCLUSIONS: The Freestyle stentless bioprosthesis is a valuable option to reconstruct the LVOT after debridement in extensive @entity886 . It is readily available with a versatility and clinical outcome comparable with that of homografts. Although early mortality remains considerable in this high-risk group of @entity1 , late survival is good with low rates of recurrence of @entity884 , immediate local control and good haemodynamic performance on echocardiography.
