Rest and exercise haemodynamics in patients with one of two stented bioprostheses and in healthy controls with small aortic annuli

Interactive Cardiovascular and Thoracic Surgery
Sina StockHans-Hinrich Sievers

Abstract

Because bioprosthetic aortic valve replacement remains one of the most frequent cardiac surgical procedures, it is necessary to study patient haemodynamics in more detail. Until now, a few studies assessed haemodynamics during exercise, but none with special regard to small aortic annuli. We compared patients who had the differently designed bioprostheses, Trifecta and Perimount Magna Ease (PME), size ≤ 23 mm, and a healthy control group during rest and exercise. We determined the mean transvalvular gradient, the effective orifice area (EOA) and the EOA index during rest and exercise using transthoracic echocardiography in 35 patients with the Trifecta (mean age 71.4 years, follow-up 1 year, labelled valve size 21.7 mm), in 16 patients with the PME (mean age 66.2 years, follow-up 2.6 years, labelled valve size 21.6 mm) and in 25 healthy persons. The parameters derived were summarized in a simplified Valve Academic Research Consortium-2 classification to determine prosthetic valve dysfunction. When we compared the Trifecta and the PME, a significant superiority of the Trifecta was seen at rest in mean transvalvular gradient (7.96 vs 12.19 mmHg) and EOA (1.57 vs 1.48 cm2), during exercise in all parameters (mean transvalvular gra...Continue Reading

References

Jul 1, 1978·Circulation·S H Rahimtoola
Mar 20, 2010·The Journal of Thoracic and Cardiovascular Surgery·Hans-H SieversMatthias Bechtel
Oct 23, 2012·The Journal of Thoracic and Cardiovascular Surgery·A Pieter KappeteinUNKNOWN Valve Academic Research Consortium-2
Jul 23, 2013·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Thorsten HankeHans-H Sievers
Mar 25, 2014·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Franck LevyChristophe Tribouilloy
Oct 1, 2014·JAMA : the Journal of the American Medical Association·Yuting P ChiangNatalia N Egorova
Feb 11, 2015·The Annals of Thoracic Surgery·Douglas R JohnstonEugene H Blackstone
Mar 15, 2015·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Andrea ColliGino Gerosa
Jan 29, 2016·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·David S BachG Michael Deeb
May 17, 2017·The Thoracic and Cardiovascular Surgeon·Shilpa AlexPallav Shah
Jun 24, 2017·Interactive Cardiovascular and Thoracic Surgery·Sina StockMichael Scharfschwerdt

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Citations

Jul 19, 2019·Expert Review of Medical Devices·Paris D KalogerakosGeorge Lazopoulos
Nov 30, 2019·Interactive Cardiovascular and Thoracic Surgery·Michiel D VriesendorpRobert J M Klautz

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