The Annals of Thoracic Surgery, Vol 24, 149-155, Copyright © 1977 by The Society of Thoracic Surgeons
Sequential hemodynamic studies in patients having aortic valve replacement with the Ionescu-Shiley pericardial xenograft
AP Tandon, DR Smith, DA Mary and MI Ionescu
Sequential hemodynamic studies were performed in 13 patients having aortic
valve replacement with glutaraldehyde-stabilized pericardial xenografts.
The investigation done preoperatively was repeated twice in all patients at
mean intervals of 9.9 and 42.2 months following valve replacement. Annulus
diameters of the valves were 19, 23, and 25 mm. Between the preoperative
and the first postoperative investigation there was a significant increase
in cardiac index (p less than 0.05) and a significant reduction in both
pulmonary wedge and left ventricular end-diastolic pressures (p less than
0.01). At the first postoperative study the mean ejection systolic gradient
across the three sizes of aortic pericardial xenograft was 7, 15.7, and 8.4
mm Hg at rest and 10, 19.6, and 13.7 mm Hg on exercise, respectively. The
corresponding surface areas of the three valve sizes were 1.1, 1.5, and
1.62 cm2 at rest and 1.4, 2.1, and 2.03 cm2 on exercise. There was no
significant change in any of these measurements between the first and the
second postoperative study. The results have shown considerable
postoperative hemodynamic improvement, insignificant transvalvular pressure
gradients, and maintenance of the functional integrity of the pericardial
xenograft up to 56 months following valve insertion.
