Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Hemodynamic Performance of Pericardial Bioprostheses in the Aortic Position

  • Lee, Haeju (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital) ;
  • Hwang, Ho Young (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital) ;
  • Sohn, Suk Ho (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital) ;
  • Choi, Jae Woong (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital) ;
  • Park, Jun-Bean (Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital) ;
  • Kim, Kyung Hwan (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital) ;
  • Kim, Ki-Bong (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital)
  • Received : 2019.12.30
  • Accepted : 2020.05.16
  • Published : 2020.10.30
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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 ㎠, 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 ㎠/㎡) and severe (EOA index ≤0.65 ㎠/㎡) 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.

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References

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