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Hemodynamic Performance of Pericardial Bioprostheses in the Aortic Position

이해주, 황호영, Sohn Suk-Ho, 최재웅, 박준빈, 김경환, 김기봉,
소속 상세정보
이해주 ( Lee Hae-Ju ) - Seoul National University Hospital Department of Thoracic and Cardiovascular Surgery
황호영 ( Hwang Ho-Young ) - Seoul National University Hospital Department of Thoracic and Cardiovascular Surgery
 ( Sohn Suk-Ho ) - Seoul National University Hospital Department of Thoracic and Cardiovascular Surgery
최재웅 ( Choi Jae-Woong ) - Seoul National University Hospital Department of Thoracic and Cardiovascular Surgery
박준빈 ( Park Jun-Bean ) - Seoul National University Hospital Department of Internal Medicine
김경환 ( Kim Kyung-Hwan ) - Seoul National University Hospital Department of Thoracic and Cardiovascular Surgery
김기봉 ( Kim Ki-Bong ) - Seoul National University Hospital Department of Thoracic and Cardiovascular Surgery

Abstract


Background: This study was conducted to evaluate the hemodynamic performance and the incidence of prosthesis-patient mismatch (PPM) after aortic valve replacement (AVR) using bovine pericardial valves (Carpentier-Edwards Perimount Magana and Magna Ease).

Methods: In total, 216 patients (mean age, 70.0±10.5 years) who underwent AVR using stented bovine pericardial valves and had follow-up echocardiography between 3 months and 2 years (mean, 12.0±6.6 months) after surgery were enrolled. The implanted valve sizes were 19, 21, 23, and 25 mm in 32, 56, 99, and 29 patients, respectively.

Results: On follow-up echocardiography, the mean transvalvular pressure gradients for the 19-mm, 21-mm, 23-mm, and 25-mm valves were 13.3±4.4, 12.6±4.2, 10.5±3.9, and 10.2± 3.7 mm Hg, respectively. The effective orifice area (EOA) was 1.25±0.26, 1.54±0.31, 1.81±0.41, and 1.87±0.33 cm2, respectively. These values were smaller than those suggested by the manufacturer for the corresponding sizes. No patients had PPM, when based on the reference EOA. However, moderate (EOA index ≤0.85 cm2/m2) and severe (EOA index ≤0.65 cm2/m2) PPM was present in 56 patients (11.8%) and 9 patients (1.9%), respectively, when using the measured values.

Conclusion: Carpentier-Edwards Perimount Magna and Magna Ease bovine pericardial valves showed satisfactory hemodynamic performance with low rates of PPM, although the reference EOA could overestimate the true EOA for individual patients.

키워드

Aortic valve; Surgery; Heart valves; Bioprosthesis; Hemodynamics

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