Background and aim of the study: Stentless aortic valve prostheses usually require two separate suture lines. The Freedom Solo valve (Sorin Group, Saluggia, Italy), by using a minimized implantation technique, requires only a single running suture line of 4-0 polypropylene. Herein are reported the surgical experience and early hemodynamic results obtained with this new valve.
Methods: Following annular decalcification, the Freedom Solo prosthesis was implanted in the supraannular aortic position in the sinuses of Valsalva of 82 patients (52 females, 30 males; mean age 76.6 ± 7.0 years). Echocardiography was performed to monitor gradients and regurgitation.
Results: The logistic EuroSCORE was 12.8 ± 9.9. Isolated aortic valve replacement was performed in 48 patients; concomitant procedures included

coronary artery bypass grafting, mitral procedures, subvalvular myectomy, and atrial ablation. The mean valve size implanted was 26.4 ± 2.1 mm, and cross-clamp time was 39.0 ± 7.0 min in primary isolated valve replacement. Non-valve-related 30-day mortality was 3.6%. At discharge, hemodynamic parameters were favorable, with low peak (16.2 ± 8.0 mmHg) and mean (8.3 ± 4.5 mmHg) gradients, and without paravalvular leakage and only minimal regurgitation (grade <I°) in 10 patients.
Conclusion: Supraannular implantation of the Freedom Solo stentless valve is safe and reliable, using a single suture line. The valve provides excellent hemodynamics at hospital discharge, without paravalvular leakage. The reduced cross-clamp time represents an attractive surgical alternative in elderly patients.
The Journal of Heart Valve Disease 2006;15:429-432