Resolution of perivalvular hematoma of the Freestyle stentless aortic root bioprosthesis implanted with a subcoronary technique

The modified subcoronary technique is frequently used to implant the Freestyle aortic root bioprosthesis because of its ease. This technique is primarily associated with hematoma in the potential space between the prosthetic and native aortic walls. We report a case of resolution of perivalvular hematoma around the Freestyle valve 6 months after implantation in a patient with aneurysm of the noncoronary sinus of Valsalva. During follow-up, the patient underwent no significant changes in pressure gradient or degree of regurgitation. Although long-term results are not yet known, the subcoronary technique may be a feasible alternative for patients with aneurysms in the sinus of Valsalva to exclude it, unless the sinotubular junction and aortic annulus are intact.