Cor Vasa 2007, 49(7-8):245-249 | DOI: 10.33678/cor.2007.094

Our experience with aortic bioprostheses

Petr Šantavý, Marián Benčat, Martin Troubil, Pavel Marcián, Vilém Bruk, Petr Němec

Šantavý P, Benčat M, Troubil M, Marcián P, Bruk V, Němec P (Kardiochirurgická klinika, Fakultní nemocnice Olomouc a Lékařská fakulta Univerzity Palackého, Olomouc, Česká republika).

Objective:
Valve replacement surgery in the case of degenerative aortic stenosis is a most frequent procedure. The purpose of this study was to compare the hemodynamic parameters of different types of bioprostheses.

Methods:
Between March 2002 and September 2006, a total of 277 aortic bioprostheses were implanted at our institution (70% of all aortic prostheses). The bioprostheses used were as follows: Edwards Lifesciences (models 2650, 2900, 3000), Medtronic-Hall (Mosaic), SJM (Epic, Epic supra), and Sorin (More, Soprano). One hundred and fifty four men and 123 women, mean age 74 ± 6 years, were included into the study. We measured the inner and outer diameters of the bioprostheses before implantation. Complete echocardiographic examination at rest was performed, and gradients and effective orifice area were calculated.

Results:
The sizes of the bioprostheses supplied by manufacturers were found to be different from what we measured: there appeared to be little correspondence to either the inner or outer valve diameter. Sorin (Soprano) showed the closest approximation. Effective orifice areas of bioprostheses measured by Doppler and continuity equation were smaller than the values published by the manufacturers, which are obtained in vitro. According to our measurements, Edwards, SJM and Sorin (Soprano) bioprostheses showed better results than Medtronic-Hall (Mosaic) and Sorin (More). An effective orifice area of the prosthesis indexed on a body surface area larger than 0.85 cm2/m2 is difficult to attain.

Conclusions:
When implanting a bioprosthesis, it is important to know its postoperative hemodynamic parameters. Based on the differences found in our study, the spectrum of bioprostheses implanted at our institution has partly changed since.

Keywords: Aortic bioprosthesis; Effective orifice area; Peak and mean gradient

Published: July 1, 2007  Show citation