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2 results on '"aortic valve prosthetis"'

1. Hemodynamic assessment of Perceval sutureless bioprosthesis by dobutamine stress echocardiography

Author

Rubino, A. S. (Antonino S.), Biancari, F. (Fausto), Caruso, V. (Vincenzo), Lavanco, V. (Vincenzo), Privitera, F. (Fiorella), Rinaldi, I. (Ivana), Sanfilippo, M. (Maria), Millan, G. (Giovanni), D’Urso, L. V. (Lucia V.), Castorina, S. (Sergio), Mignosa, C. (Carmelo), Rubino, A. S. (Antonino S.), Biancari, F. (Fausto), Caruso, V. (Vincenzo), Lavanco, V. (Vincenzo), Privitera, F. (Fiorella), Rinaldi, I. (Ivana), Sanfilippo, M. (Maria), Millan, G. (Giovanni), D’Urso, L. V. (Lucia V.), Castorina, S. (Sergio), and Mignosa, C. (Carmelo)

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.

Published
2018

2. Hemodynamic assessment of Perceval sutureless bioprosthesis by dobutamine stress echocardiography

Author

Maria Sanfilippo, Giovanni Millan, Lucia D'Urso, Vincenzo Fabrizio Caruso, Fausto Biancari, Sergio Castorina, Fiorella Privitera, Ivana Rinaldi, Antonino S. Rubino, Carmelo Mignosa, Vincenzo Lavanco, Rubino, A, Biancari, F, Caruso, V, Lavanco, V, Privitera, F, Rinaldi, I, Sanfilippo, M, Millan, G, D'Urso, Lv, Castorina, S, and Mignosa, C.

Subjects
Male, medicine.medical_specialty, aortic valve prosthesis, Dobutamine stress echocardiography, medicine.medical_treatment, Hemodynamics, 030204 cardiovascular system & hematology, Stress, Prosthesis, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Aortic valve replacement, Internal medicine, dobutamine stress echocardiography, Medicine, Humans, Radiology, Nuclear Medicine and imaging, aortic valve replacement, Cardiac skeleton, aortic valve prosthetis, Aged, ta3126, Bioprosthesis, Ejection fraction, business.industry, Effective orifice area, Stroke volume, sutureless, Echocardiography, Stress, Female, Follow-Up Studies, Heart Valves, Middle Aged, Sutureless Surgical Procedures, Heart Valve Prosthesis, medicine.disease, aortic valve prosthesi, suturele, 030228 respiratory system, Echocardiography, Cardiology, Cardiology and Cardiovascular Medicine, business
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.

Published
2018

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