Hemodynamic Changes after Aortic Valve Replacement with Different Types of 19-mm Mechanical Heart Valves_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

SONGBang-rong , LAIYong-qiang , DONGRan

Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, P. R. China;

Corresponding author：

Keywords：

Prosthesis-patient mismatch; Heart valve; Heart valve replacement; Hemodynamics

DOI：

10.7507/1007-4848.20140053

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate hemodynamic changes in the early postoperative period of isolated aortic valve replacement (AVR) with different types of 19-mm mechanical heart valves. Methods Clinical data of 116 patients with aortic stenosis who underwent AVR in Beijing Anzhen hospital from January 2007 to January 2012 were retrospectively analyzed. There were 61 male and 55 female patients with their age of 52±13 years. All the patients were divided into 3 groups according to different types of mechanical heart valves they received. In SJ. Regent valve group,there were 38 patients (33%) including 20 males and 18 females with their average age of 52±15 years. In Carbomedics valve group,there were 40 patients (34%) including 21 males and 19 females with their average age of 51±17 years. In On-X valve group,there were 38 patients (33%) including 20 male and 18 female patients with their average age of 55±16 years. Preoperative and postoperative left ventricular end-systolic diameter (LVESD) left ventricular end-diastolic diameter (LVEDD) ejection fraction (EF) interventricular septal thickness,left ventricular wall thickness,trans-aortic valve velocity and pressure,and postoperative effective orifice area index (EOAI) were compared. Results There was no statistical difference in preoperative and postoperative LVESD,LVEDD,EF,interventricular septum thickness and left ventricular wall thickness among the 3 groups (P>0.05). There was statistical difference in preoperative and postoperative trans-aortic valve velocity and pressure. Trans-aortic valve velocity of SJ. Regent valve group and Carbomedics valve group (244.30±33.67 cm/s vs. 249.69±79.13 cm/s vs. 294.83±52.05 cm/s) and trans-aortic valve pressure of SJ.Regent valve group and Carbomedics valve group (27.77±3.33 mm Hg vs. 33.58±18.90 mm Hg vs. 38.56±13.21 mm Hg) were significantly smaller than those of On-X valve group. Conclusion St. Regent and Carbomedics mechanical heart valves demonstrate better hemodynamics in AVR patients receiving 19-mm mechanical heart valves.

Citation： SONGBang-rong, LAIYong-qiang, DONGRan. Hemodynamic Changes after Aortic Valve Replacement with Different Types of 19-mm Mechanical Heart Valves. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2014, 21(2): 174-177. doi: 10.7507/1007-4848.20140053 Copy

1.	Svensson LG,Adams DH,Bonow RO,et al.Aortic valve and ascending aorta guidelines for management and quality measures.Ann Thorac Surg,2013,95 (6 Suppl):S1-S66.
2.	Christakis GT,Goldman BS.Do small aortic valves influence long-term survival? Ann Thorac Surg,1997,63 (4):933-934.
3.	Lund O,Emmertsen K,Nielsen TT,et al.Impact of size mismatch and left ventricular function on performance of the St.Jude disc valve after aortic valve replacement.Ann Thorac Surg,1997,63 (5):1227-1234.
4.	Gonzalez-Juanatey JR,Garcia-Bengoechea JB,Garcia-Acuna JM,et al.The influence of the design on the medium to long-term hemodynamic behavior of 19 mm pericardial aortic valve prostheses.J Heart Valve Dis,1996,5 (Suppl 3):317-323.
5.	Barner HB,Labovitz AJ,Fiore AC.Prosthetic valves for the small aortic root.J Card Surg,1994,9 (2 Suppl):154-157.
6.	Kratz JM,Sade RM,Crawford FA,et al.The risk of small St.Jude aortic valve prostheses.Ann Thorac Surg,1994,57 (5):1114-1118.
7.	Rahimtoola SH.The problem of valve prosthesis-patient mismatch.Circulation,1978,58 (1):20-24.
8.	David TE.Surgical treatment of aortic valve disease.Nat Rev Cardiol,2013,10 (7):375-386.
9.	Bianco JC,Qizilbash B,Carrier M,et al.Is patient-prosthesis mismatch a perioperative predictor of long-term mortality after aortic valve replacement? J Cardiothorac Vasc Anesth,2013,27 (4):647-653.
10.	Kobayashi Y,Fukushima Y,Hayase T,et al.Clinical outcome of aortic valve replacement with 16-mm ATS-advanced performance valve for small aortic annulus.Ann Thorac Surg,2010,89 (4):1195-1199.
11.	Minardi G,Manzara C,Creazzo V,et al.Evaluation of 17-mm St.Jude medical regent prosthetic aortic heart valves by rest and dobutamine stress echocardiography.J Cardiothorac Surg,2006,1:27.
12.	Finkelstein A,Schwartz AL,Uretzky G,et al.Hemodynamic performance and outcome of percutaneous versus surgical stentless bioprostheses for aortic stenosis with anticipated patient-prosthesis mismatch.J Thorac Cardiovasc Surg,2013.[Epub ahead of print].
13.	Chacko SJ,Ansari AH,McCarthy PM,et al.Prosthesis-patient mismatch in bovine pericardial aortic valves:evaluation using 3 different modalities and associated medium-term outcomes.Circ Cardiovasc Imaging,2013,6 (5):776-783.
14.	Mohty D,Dumesnil JG,Echahidi N,et al.Impact of prosthesis-patient mismatch on long-term survival after aortic valve replacement:influence of age,obesity,and left ventricular dysfunction.J Am Coll Cardiol,2009,53 (1):39-47.
15.	Bokeria LA,Bokeria OL,Fadeev AA,et al.The assessment of mechanical heart valves stenosis in adults after aortic valve replacement:the advantage of full-flow design of mechanical valve.Vestn Ross Akad Med Nauk,2013 (3):51-58.
16.	Castro LJ,Arcidi JM,Fisher AL,et al.Routine enlargement of the small aortic root:a preventive strategy to minimize mismatch.Ann Thorac Surg,2002,74 (1):31-36.
17.	Del Rizzo DF,Goldman BS,Christakis GT,et al.Hemodynamic benefits of the Toronto Stentless Valve.J Thorac Cardiovasc Surg,1996,112 (6):1431-1445.
18.	Kon ND,Westaby S,Amarasena N,et al.Comparison of implantation techniques using freestyle stentless porcine aortic valve.Ann Thorac Surg,1995,59 (4):857-862.

1. Svensson LG,Adams DH,Bonow RO,et al.Aortic valve and ascending aorta guidelines for management and quality measures.Ann Thorac Surg,2013,95 (6 Suppl):S1-S66.
2. Christakis GT,Goldman BS.Do small aortic valves influence long-term survival? Ann Thorac Surg,1997,63 (4):933-934.
3. Lund O,Emmertsen K,Nielsen TT,et al.Impact of size mismatch and left ventricular function on performance of the St.Jude disc valve after aortic valve replacement.Ann Thorac Surg,1997,63 (5):1227-1234.
4. Gonzalez-Juanatey JR,Garcia-Bengoechea JB,Garcia-Acuna JM,et al.The influence of the design on the medium to long-term hemodynamic behavior of 19 mm pericardial aortic valve prostheses.J Heart Valve Dis,1996,5 (Suppl 3):317-323.
5. Barner HB,Labovitz AJ,Fiore AC.Prosthetic valves for the small aortic root.J Card Surg,1994,9 (2 Suppl):154-157.
6. Kratz JM,Sade RM,Crawford FA,et al.The risk of small St.Jude aortic valve prostheses.Ann Thorac Surg,1994,57 (5):1114-1118.
7. Rahimtoola SH.The problem of valve prosthesis-patient mismatch.Circulation,1978,58 (1):20-24.
8. David TE.Surgical treatment of aortic valve disease.Nat Rev Cardiol,2013,10 (7):375-386.
9. Bianco JC,Qizilbash B,Carrier M,et al.Is patient-prosthesis mismatch a perioperative predictor of long-term mortality after aortic valve replacement? J Cardiothorac Vasc Anesth,2013,27 (4):647-653.
10. Kobayashi Y,Fukushima Y,Hayase T,et al.Clinical outcome of aortic valve replacement with 16-mm ATS-advanced performance valve for small aortic annulus.Ann Thorac Surg,2010,89 (4):1195-1199.
11. Minardi G,Manzara C,Creazzo V,et al.Evaluation of 17-mm St.Jude medical regent prosthetic aortic heart valves by rest and dobutamine stress echocardiography.J Cardiothorac Surg,2006,1:27.
12. Finkelstein A,Schwartz AL,Uretzky G,et al.Hemodynamic performance and outcome of percutaneous versus surgical stentless bioprostheses for aortic stenosis with anticipated patient-prosthesis mismatch.J Thorac Cardiovasc Surg,2013.[Epub ahead of print].
13. Chacko SJ,Ansari AH,McCarthy PM,et al.Prosthesis-patient mismatch in bovine pericardial aortic valves:evaluation using 3 different modalities and associated medium-term outcomes.Circ Cardiovasc Imaging,2013,6 (5):776-783.
14. Mohty D,Dumesnil JG,Echahidi N,et al.Impact of prosthesis-patient mismatch on long-term survival after aortic valve replacement:influence of age,obesity,and left ventricular dysfunction.J Am Coll Cardiol,2009,53 (1):39-47.
15. Bokeria LA,Bokeria OL,Fadeev AA,et al.The assessment of mechanical heart valves stenosis in adults after aortic valve replacement:the advantage of full-flow design of mechanical valve.Vestn Ross Akad Med Nauk,2013 (3):51-58.
16. Castro LJ,Arcidi JM,Fisher AL,et al.Routine enlargement of the small aortic root:a preventive strategy to minimize mismatch.Ann Thorac Surg,2002,74 (1):31-36.
17. Del Rizzo DF,Goldman BS,Christakis GT,et al.Hemodynamic benefits of the Toronto Stentless Valve.J Thorac Cardiovasc Surg,1996,112 (6):1431-1445.
18. Kon ND,Westaby S,Amarasena N,et al.Comparison of implantation techniques using freestyle stentless porcine aortic valve.Ann Thorac Surg,1995,59 (4):857-862.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Hemodynamic Changes after Aortic Valve Replacement with Different Types of 19-mm Mechanical Heart Valves

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content