Sung K, Park PW, Park KH, Jun TG, Lee YT, Yang JH. Comparison of transprosthetic mean pressure gradients between Medtronic Hall and ATS valves in the aortic position.
Int J Cardiol 2005;
99:29-35. [PMID:
15721496 DOI:
10.1016/j.ijcard.2003.10.066]
[Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2003] [Revised: 09/09/2003] [Accepted: 10/12/2003] [Indexed: 11/22/2022]
Abstract
AIM OF THE STUDY
Several studies have shown the inferior performance of small prostheses in the narrow aortic root. However, modern low-profile mechanical prostheses have improved hemodynamic performance characteristics. By measuring the transprosthetic pressure gradient in vivo, we were able to characterize the hemodynamic features of two prostheses: the ATS Medical (ATS) and the Medtronic Hall (MH) valves.
METHODS
From October 1994 to April 2002, 113 patients received an aortic valve replacement (AVR) with either an ATS or a MH valve. The transprosthetic pressure gradients, calculated from a simplified Bernoulli equation during immediate postoperative Doppler echocardiographic examination, were compared for differently sized prostheses with respect to body surface area (BSA).
RESULTS
The mean pressure gradients and the mean BSAs were: 27.8 +/- 14.8 mm Hg and 1.50 +/- 0.10 m(2) in ATS 19 mm (n = 7), 20.4 +/- 8.5 mm Hg and 1.54 +/- 0.11 m(2) in ATS 21 mm (n = 22), 13.0 +/- 5.7 mm Hg, 1.70 +/- 0.13 m(2) in ATS 23 mm (n = 22), 10.9 +/- 3.5 mm Hg and 1.81 +/ -0.16 m(2) in ATS 25 mm (n = 19), 9.3 +/- 0.6 mm Hg and 1.72 +/- 0.17 m(2) in ATS 27 mm (n = 4), 13.5 +/- 6.5 mm Hg and 1.54 +/- 0.13 m(2) in MH 20 mm (n = 9), 10.9 +/- 4.7 mm Hg and 1.64 +/- 0.15 m(2) in MH 22 mm (n = 22), 9.3 +/- 3.1 mm Hg and 1.72 +/- 0.12 m(2) in MH 24 mm (n = 7).
CONCLUSIONS
With the exception of the ATS 19-mm valve, the variously sized prostheses have acceptable transprosthetic pressure gradient measurements. In addition, even-sized MH valves (20 and 22 mm) with a thinner sewing cuff showed better hemodynamic performances than similarly sized ATS valves.
Collapse