Hemodynamic performance of small aortic valve bioprostheses: Is there a difference?

Monica L. McDonald, Richard C. Daly, Hartzell V Schaff, Charles J. Mullany, Fletcher A Jr. Miller, James J. Morris, Thomas A. Orszulak

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Background. There is the potential for left ventricular outflow obstruction when small aortic valve bioprostheses are employed in normal-sized or large adults. It has been hoped that bovine pericardial valves would improve hemodynamic performance in the smaller tissue valve sizes. Methods. To determine in vivo hemodynamic performance of heterograft aortic valve prostheses, we analyzed echocardiographic data from patients receiving 21 or 23-mm Carpentier-Edwards pericardial, Medtronic Intact, and Carpentier-Edwards porcine bioprostheses. In addition, data from 19-mm Carpentier-Edwards pericardial valves were included for comparison of hemodynamic performance between valve sizes. Doppler echocardiography was performed in 151 patients within 2 weeks of operation. Left ventricular outflow gradient was derived from continuous Doppler measurements of flow velocity, and effective orifice area was calculated by the continuity equation. Results. There were statistically significant differences in hemodynamic performance of different sized prostheses for each valve type (effective orifice area, p < 0.01; valvular gradient, p < 0.03). There were, however, no signiticant differences in effective orifice area or mean gradient for different valve types within each size category. Conclusions. The in vivo hemodynamic performance of these three different aortic valve heterograft bioprostheses is similar. Patient-prosthesis mismatch with heterograft prostheses, as demonstrated by the indexed effective orifice area can be avoided by appropriate sizing and use of annular enlarging techniques when necessary.

Original languageEnglish (US)
Pages (from-to)362-366
Number of pages5
JournalAnnals of Thoracic Surgery
Volume63
Issue number2
DOIs
StatePublished - Feb 1997

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Bioprosthesis
Aortic Valve
Hemodynamics
Prostheses and Implants
Heterografts
Ventricular Outflow Obstruction
Doppler Echocardiography
Swine

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Hemodynamic performance of small aortic valve bioprostheses : Is there a difference? / McDonald, Monica L.; Daly, Richard C.; Schaff, Hartzell V; Mullany, Charles J.; Miller, Fletcher A Jr.; Morris, James J.; Orszulak, Thomas A.

In: Annals of Thoracic Surgery, Vol. 63, No. 2, 02.1997, p. 362-366.

Research output: Contribution to journalArticle

McDonald, Monica L. ; Daly, Richard C. ; Schaff, Hartzell V ; Mullany, Charles J. ; Miller, Fletcher A Jr. ; Morris, James J. ; Orszulak, Thomas A. / Hemodynamic performance of small aortic valve bioprostheses : Is there a difference?. In: Annals of Thoracic Surgery. 1997 ; Vol. 63, No. 2. pp. 362-366.
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