Hemodynamic evaluation of 19-mm Carpentier-Edwards pericardial bioprosthesis in aortic position

Hiromitsu Takakura, Tatsuumi Sasaki, Kazuhiro Hashimoto, Takashi Hachiya, Katsuhisa Onoguchi, Motohiro Oshiumi, Shigeyuki Takeuchi

Research output: Contribution to journalArticle

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Abstract

Background. The aortic Carpentier-Edwards pericardial bioprosthesis offers good long-term clinical outcomes with a low rate of structural deterioration. However, little in vivo hemodynamic data is available for this bioprosthesis. Methods. To determine the hemodynamic performance of the 19-mm Carpentier-Edwards pericardial valve, both cardiac catheterization and dobutamine stress echocardiography were electively performed in 10 patients. The mean age at the study was 71.6 ± 4.4 years and the mean body surface area was 1.39 ± 0.11 m2. The peak-to-peak gradient, instantaneous peak gradient, mean gradient, and valve orifice area were measured by standard cardiac catheterization. The Doppler-derived gradients and valve orifice area were also measured both at rest and during dobutamine infusion. Results. The average peak-to-peak gradient, instantaneous peak gradient, mean gradient, and valve orifice area measured by catheterization were 13.0 ± 5.4 mmHg, 28.5 ± 7.7 mmHg, 12.0 ± 4.9 mmHg, and 1.55 ± 0.45 cm2, respectively. The peak and mean Doppler gradients, and valve orifice area by resting echocardiography were 27.7 ± 9.5 mmHg, 12.3 ± 4.8 mmHg, and 1.39 ± 0.26 cm2, respectively. At a dosage of 10 μg/kg/min of dobutamine, the mean Doppler gradient rose mildly to 22.2 ± 4.8 mmHg, while the cardiac output increased from 4.49 ± 0.44 to 6.64 ± 0.87 L/min. The valve orifice area during the 10 μg/kg/min dobutamine infusion (1.55 ± 0.25 cm2) was significantly larger than its value at rest (p < 0.05). Conclusions. With acceptable hemodynamic performance, use of the aortic 19-mm Carpentier-Edwards pericardial valve is a reliable option for elderly patients with a small annulus.

Original languageEnglish
Pages (from-to)609-613
Number of pages5
JournalAnnals of Thoracic Surgery
Volume71
Issue number2
DOIs
Publication statusPublished - 2001

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Bioprosthesis
Dobutamine
Hemodynamics
Cardiac Catheterization
Stress Echocardiography
Body Surface Area
Catheterization
Cardiac Output
Echocardiography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Takakura, H., Sasaki, T., Hashimoto, K., Hachiya, T., Onoguchi, K., Oshiumi, M., & Takeuchi, S. (2001). Hemodynamic evaluation of 19-mm Carpentier-Edwards pericardial bioprosthesis in aortic position. Annals of Thoracic Surgery, 71(2), 609-613. https://doi.org/10.1016/S0003-4975(00)02210-4

Hemodynamic evaluation of 19-mm Carpentier-Edwards pericardial bioprosthesis in aortic position. / Takakura, Hiromitsu; Sasaki, Tatsuumi; Hashimoto, Kazuhiro; Hachiya, Takashi; Onoguchi, Katsuhisa; Oshiumi, Motohiro; Takeuchi, Shigeyuki.

In: Annals of Thoracic Surgery, Vol. 71, No. 2, 2001, p. 609-613.

Research output: Contribution to journalArticle

Takakura, H, Sasaki, T, Hashimoto, K, Hachiya, T, Onoguchi, K, Oshiumi, M & Takeuchi, S 2001, 'Hemodynamic evaluation of 19-mm Carpentier-Edwards pericardial bioprosthesis in aortic position', Annals of Thoracic Surgery, vol. 71, no. 2, pp. 609-613. https://doi.org/10.1016/S0003-4975(00)02210-4
Takakura, Hiromitsu ; Sasaki, Tatsuumi ; Hashimoto, Kazuhiro ; Hachiya, Takashi ; Onoguchi, Katsuhisa ; Oshiumi, Motohiro ; Takeuchi, Shigeyuki. / Hemodynamic evaluation of 19-mm Carpentier-Edwards pericardial bioprosthesis in aortic position. In: Annals of Thoracic Surgery. 2001 ; Vol. 71, No. 2. pp. 609-613.
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abstract = "Background. The aortic Carpentier-Edwards pericardial bioprosthesis offers good long-term clinical outcomes with a low rate of structural deterioration. However, little in vivo hemodynamic data is available for this bioprosthesis. Methods. To determine the hemodynamic performance of the 19-mm Carpentier-Edwards pericardial valve, both cardiac catheterization and dobutamine stress echocardiography were electively performed in 10 patients. The mean age at the study was 71.6 ± 4.4 years and the mean body surface area was 1.39 ± 0.11 m2. The peak-to-peak gradient, instantaneous peak gradient, mean gradient, and valve orifice area were measured by standard cardiac catheterization. The Doppler-derived gradients and valve orifice area were also measured both at rest and during dobutamine infusion. Results. The average peak-to-peak gradient, instantaneous peak gradient, mean gradient, and valve orifice area measured by catheterization were 13.0 ± 5.4 mmHg, 28.5 ± 7.7 mmHg, 12.0 ± 4.9 mmHg, and 1.55 ± 0.45 cm2, respectively. The peak and mean Doppler gradients, and valve orifice area by resting echocardiography were 27.7 ± 9.5 mmHg, 12.3 ± 4.8 mmHg, and 1.39 ± 0.26 cm2, respectively. At a dosage of 10 μg/kg/min of dobutamine, the mean Doppler gradient rose mildly to 22.2 ± 4.8 mmHg, while the cardiac output increased from 4.49 ± 0.44 to 6.64 ± 0.87 L/min. The valve orifice area during the 10 μg/kg/min dobutamine infusion (1.55 ± 0.25 cm2) was significantly larger than its value at rest (p < 0.05). Conclusions. With acceptable hemodynamic performance, use of the aortic 19-mm Carpentier-Edwards pericardial valve is a reliable option for elderly patients with a small annulus.",
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AU - Takakura, Hiromitsu

AU - Sasaki, Tatsuumi

AU - Hashimoto, Kazuhiro

AU - Hachiya, Takashi

AU - Onoguchi, Katsuhisa

AU - Oshiumi, Motohiro

AU - Takeuchi, Shigeyuki

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N2 - Background. The aortic Carpentier-Edwards pericardial bioprosthesis offers good long-term clinical outcomes with a low rate of structural deterioration. However, little in vivo hemodynamic data is available for this bioprosthesis. Methods. To determine the hemodynamic performance of the 19-mm Carpentier-Edwards pericardial valve, both cardiac catheterization and dobutamine stress echocardiography were electively performed in 10 patients. The mean age at the study was 71.6 ± 4.4 years and the mean body surface area was 1.39 ± 0.11 m2. The peak-to-peak gradient, instantaneous peak gradient, mean gradient, and valve orifice area were measured by standard cardiac catheterization. The Doppler-derived gradients and valve orifice area were also measured both at rest and during dobutamine infusion. Results. The average peak-to-peak gradient, instantaneous peak gradient, mean gradient, and valve orifice area measured by catheterization were 13.0 ± 5.4 mmHg, 28.5 ± 7.7 mmHg, 12.0 ± 4.9 mmHg, and 1.55 ± 0.45 cm2, respectively. The peak and mean Doppler gradients, and valve orifice area by resting echocardiography were 27.7 ± 9.5 mmHg, 12.3 ± 4.8 mmHg, and 1.39 ± 0.26 cm2, respectively. At a dosage of 10 μg/kg/min of dobutamine, the mean Doppler gradient rose mildly to 22.2 ± 4.8 mmHg, while the cardiac output increased from 4.49 ± 0.44 to 6.64 ± 0.87 L/min. The valve orifice area during the 10 μg/kg/min dobutamine infusion (1.55 ± 0.25 cm2) was significantly larger than its value at rest (p < 0.05). Conclusions. With acceptable hemodynamic performance, use of the aortic 19-mm Carpentier-Edwards pericardial valve is a reliable option for elderly patients with a small annulus.

AB - Background. The aortic Carpentier-Edwards pericardial bioprosthesis offers good long-term clinical outcomes with a low rate of structural deterioration. However, little in vivo hemodynamic data is available for this bioprosthesis. Methods. To determine the hemodynamic performance of the 19-mm Carpentier-Edwards pericardial valve, both cardiac catheterization and dobutamine stress echocardiography were electively performed in 10 patients. The mean age at the study was 71.6 ± 4.4 years and the mean body surface area was 1.39 ± 0.11 m2. The peak-to-peak gradient, instantaneous peak gradient, mean gradient, and valve orifice area were measured by standard cardiac catheterization. The Doppler-derived gradients and valve orifice area were also measured both at rest and during dobutamine infusion. Results. The average peak-to-peak gradient, instantaneous peak gradient, mean gradient, and valve orifice area measured by catheterization were 13.0 ± 5.4 mmHg, 28.5 ± 7.7 mmHg, 12.0 ± 4.9 mmHg, and 1.55 ± 0.45 cm2, respectively. The peak and mean Doppler gradients, and valve orifice area by resting echocardiography were 27.7 ± 9.5 mmHg, 12.3 ± 4.8 mmHg, and 1.39 ± 0.26 cm2, respectively. At a dosage of 10 μg/kg/min of dobutamine, the mean Doppler gradient rose mildly to 22.2 ± 4.8 mmHg, while the cardiac output increased from 4.49 ± 0.44 to 6.64 ± 0.87 L/min. The valve orifice area during the 10 μg/kg/min dobutamine infusion (1.55 ± 0.25 cm2) was significantly larger than its value at rest (p < 0.05). Conclusions. With acceptable hemodynamic performance, use of the aortic 19-mm Carpentier-Edwards pericardial valve is a reliable option for elderly patients with a small annulus.

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