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Rubino AS, Biancari F, Caruso V, Lavanco V, Privitera F, Rinaldi I, Sanfilippo M, Millan G, D'Urso LV, Castorina S, Mignosa C. Hemodynamic assessment of Perceval sutureless bioprosthesis by dobutamine stress echocardiography. Echocardiography 2017; 35:64-70. [PMID: 29071795 DOI: 10.1111/echo.13735] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the hemodynamic performance of a sutureless bioprosthesis under high workload at mid-term follow-up. METHODS Thirty-two patients who underwent isolated aortic valve replacement with a Perceval sutureless bioprosthesis with a minimum follow-up of 1 year were enrolled in this study. S size prosthesis was deployed in 10 patients (31.3%), M size in 9 (28.1%), L size in 8 (25%) and XL size in 5 (15.6%). Effective orifice area (EOA), EOA index (EOAi), and transvalvular gradients were assessed at rest and during dobutamine stress echocardiography (DSE) a median of 19.5 months after surgery. RESULTS Dobutamine stress echocardiography (DSE) significantly increased heart rate, stroke volume, ejection fraction, and transvalvular gradients (peak gradient, 24.0 ± 7.6 vs 38.7 ± 13.6 mm Hg, P < .001; mean gradient, 12.6 ± 4.2 vs 19.8 ± 8.3, P < .001). When compared to baseline, estimated valve areas significantly increased at follow-up (EOA, 1.48 ± 0.46 vs 2.06 ± 0.67, P < .001; EOAi, 0.84 ± 0.26 vs 1.17 ± 0.37, P < .001). Mean percentage increase in EOAi was 40.3% ± 28.0%. S size prostheses had the highest increase in EOA1, but the difference was not significant (S 46.0% ± 27.5% vs M 45.4% ± 34.5% vs L 32.7% ± 26.4% vs XL 32.1% ± 20.5%, P = .66). Severe patient-prosthesis mismatch (EOAi ≤ 0.65 cm2 /m2 ) was present at rest in 8 patients (25%), but only in one patient (3.1%) during DSE. CONCLUSIONS The Perceval sutureless bioprosthesis demonstrated good hemodynamics at rest and under high workload. The significant increase in EOAi during DSE suggests the potential advantages of Perceval sutureless bioprostheses in case of small aortic annulus or when patient-prosthesis mismatch is anticipated.
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Affiliation(s)
- Antonino S Rubino
- Cardiac Surgery Unit, A.O.U. "Policlinico-Vittorio Emanuele", Ferrarotto Hospital, University of Catania, Catania, Italy.,Heart Center, Fondazione "G.B Morgagni", Pedara, Catania, Italy
| | - Fausto Biancari
- Heart Center, Turku University Hospital, Turku, Finland.,Department of Surgery, University of Turku, Turku, Finland.,Department of Surgery, University of Oulu, Oulu, Finland
| | - Vincenzo Caruso
- Cardiac Surgery Unit, A.O.U. "Policlinico-Vittorio Emanuele", Ferrarotto Hospital, University of Catania, Catania, Italy
| | - Vincenzo Lavanco
- Cardiology Unit, A.O.U. "Policlinico-Vittorio Emanuele", Ferrarotto Hospital, University of Catania, Catania, Italy
| | - Fiorella Privitera
- Cardiology Unit, A.O.U. "Policlinico-Vittorio Emanuele", Ferrarotto Hospital, University of Catania, Catania, Italy
| | - Ivana Rinaldi
- Cardiology Unit, A.O.U. "Policlinico-Vittorio Emanuele", Ferrarotto Hospital, University of Catania, Catania, Italy
| | - Maria Sanfilippo
- Cardiology Unit, A.O.U. "Policlinico-Vittorio Emanuele", Ferrarotto Hospital, University of Catania, Catania, Italy
| | - Giovanni Millan
- Cardiology Unit, A.O.U. "Policlinico-Vittorio Emanuele", Ferrarotto Hospital, University of Catania, Catania, Italy
| | - Lucia V D'Urso
- Cardiology Unit, A.O.U. "Policlinico-Vittorio Emanuele", Ferrarotto Hospital, University of Catania, Catania, Italy
| | - Sergio Castorina
- Heart Center, Fondazione "G.B Morgagni", Pedara, Catania, Italy.,Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Carmelo Mignosa
- Cardiac Surgery Unit, A.O.U. "Policlinico-Vittorio Emanuele", Ferrarotto Hospital, University of Catania, Catania, Italy.,Heart Center, Fondazione "G.B Morgagni", Pedara, Catania, Italy
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Xu R, Rahnavardi M, Pitman B, Shirazi M, Stuklis R, Edwards J, Worthington M. On-X versus St Jude Medical Regent mechanical aortic valve prostheses: early haemodynamics. Open Heart 2017; 4:e000539. [PMID: 28674619 PMCID: PMC5471874 DOI: 10.1136/openhrt-2016-000539] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Revised: 11/20/2016] [Accepted: 11/28/2016] [Indexed: 11/25/2022] Open
Abstract
Objective We aimed to compare the early haemodynamic data of the On-X and St Jude Medical (SJM) Regent bileaflet mechanical prostheses in the aortic position. Methods A retrospective study was performed using data collected prospectively for a national database. Thirty-three patients who had aortic On-X valve (On-X group) and 33 matched patients who had aortic SJM Regent valve (SJM group) were included. The intraoperative and early postoperative data were collected. The same echocardiographer reviewed all the echocardiograms and obtained the required parameters. Results The peak gradient across the prosthetic valve was comparable between the two groups except for the labelled valve size of 25 mm for which the On-X group had lower peak gradient when compared with the SJM group. Mean gradients and effective orifice area indices of the two valve types within each valve size subgroup were comparable. Conclusions The current study confirms that in the early postoperative period, the two valve types had comparable haemodynamic outcomes.
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Affiliation(s)
- Robert Xu
- D'Arcy Sutherland Cardiothoracic Surgical Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Mohammad Rahnavardi
- D'Arcy Sutherland Cardiothoracic Surgical Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Bradley Pitman
- Cardiology Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Masoumeh Shirazi
- Cardiology Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Robert Stuklis
- D'Arcy Sutherland Cardiothoracic Surgical Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - James Edwards
- D'Arcy Sutherland Cardiothoracic Surgical Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Michael Worthington
- D'Arcy Sutherland Cardiothoracic Surgical Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
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Kheradvar A, Groves EM, Goergen CJ, Alavi SH, Tranquillo R, Simmons CA, Dasi LP, Grande-Allen KJ, Mofrad MRK, Falahatpisheh A, Griffith B, Baaijens F, Little SH, Canic S. Emerging Trends in Heart Valve Engineering: Part II. Novel and Standard Technologies for Aortic Valve Replacement. Ann Biomed Eng 2014; 43:844-57. [DOI: 10.1007/s10439-014-1191-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 11/13/2014] [Indexed: 11/29/2022]
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