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Examining the typical hemodynamic performance of nearly 3000 modern surgical aortic bioprostheses.
Klautz, Robert J M; Rao, Vivek; Reardon, Michael J; Deeb, G Michael; Dagenais, Francois; Moront, Michael G; Little, Stephen H; Labrousse, Louis; Patel, Himanshu J; Ito, Saki; Li, Shuzhen; Sabik, Joseph F; Oh, Jae K.
Afiliación
  • Klautz RJM; Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, Netherlands.
  • Rao V; Department of Surgery, Peter Munk Cardiac Centre, Toronto General Hospital, Toronto, ON, Canada.
  • Reardon MJ; Department of Cardiovascular Surgery and Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, USA.
  • Deeb GM; Department of Cardiac Surgery, University of Michigan, Ann Arbor, MI, USA.
  • Dagenais F; Department of Cardiac Surgery, Quebec Heart and Lung Institute, Quebec, QC, Canada.
  • Moront MG; Department of Cardiothoracic Surgery, ProMedica Toledo Hospital, Toledo, OH, USA.
  • Little SH; Department of Cardiovascular Surgery and Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, USA.
  • Labrousse L; Medico-Surgical Department of Valvulopathies, Bordeaux Heart University Hospital, Bordeaux-Pessac, France.
  • Patel HJ; Department of Cardiac Surgery, University of Michigan, Ann Arbor, MI, USA.
  • Ito S; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
  • Li S; Clinical Research and Medical Science, Cardiac Surgery, Medtronic, Mounds View, MN, USA.
  • Sabik JF; Department of Surgery, University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH, USA.
  • Oh JK; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
Eur J Cardiothorac Surg ; 65(5)2024 May 03.
Article en En | MEDLINE | ID: mdl-38710669
ABSTRACT

OBJECTIVES:

The objective of this analysis was to assess the normal haemodynamic performance of contemporary surgical aortic valves at 1 year postimplant in patients undergoing surgical aortic valve replacement for significant valvular dysfunction. By pooling data from 4 multicentre studies, this study will contribute to a better understanding of the effectiveness of surgical aortic valve replacement procedures, aiding clinicians and researchers in making informed decisions regarding valve selection and patient management.

METHODS:

Echocardiograms were assessed by a single core laboratory. Effective orifice area, dimensionless velocity index, mean aortic gradient, peak aortic velocity and stroke volume were evaluated.

RESULTS:

The cohort included 2958 patients. Baseline age in the studies ranged from 70.1 ± 9.0 to 83.3 ± 6.4 years, and Society of Thoracic Surgeons risk of mortality was 1.9 ± 0.7 to 7.5 ± 3.4%. Twenty patients who had received a valve model implanted in fewer than 10 cases were excluded. Ten valve models (all tissue valves; n = 2938 patients) were analysed. At 1 year, population mean effective orifice area ranged from 1.46 ± 0.34 to 2.12 ± 0.59 cm2, and dimensionless velocity index, from 0.39 ± 0.07 to 0.56 ± 0.15. The mean gradient ranged from 8.6 ± 3.4 to 16.1 ± 6.2 mmHg with peak aortic velocity of 1.96 ± 0.39 to 2.65 ± 0.47 m/s. Stroke volume was 75.3 ± 19.6 to 89.8 ± 24.3 ml.

CONCLUSIONS:

This pooled cohort is the largest to date of contemporary surgical aortic valves with echocardiograms analysed by a single core lab. Overall haemodynamic performance at 1 year ranged from good to excellent. These data can serve as a benchmark for other studies and may be useful to evaluate the performance of bioprosthetic surgical valves over time. CLINICAL TRIAL REGISTRATION NUMBER NCT02088554, NCT02701283, NCT01586910 and NCT01531374.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Válvula Aórtica / Bioprótesis / Prótesis Valvulares Cardíacas / Implantación de Prótesis de Válvulas Cardíacas / Hemodinámica Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Cardiothorac Surg Asunto de la revista: CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Válvula Aórtica / Bioprótesis / Prótesis Valvulares Cardíacas / Implantación de Prótesis de Válvulas Cardíacas / Hemodinámica Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Cardiothorac Surg Asunto de la revista: CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Alemania