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

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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.

元の言語English
ページ(範囲)609-613
ページ数5
ジャーナルAnnals of Thoracic Surgery
71
発行部数2
DOI
出版物ステータスPublished - 2001 3 6

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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    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