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Robert M. Bojar
Hassan Rastegar
Douglas D. Payne
Charles A. Mack
Steven L. Schwartz
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Ann Thorac Surg 1993;56:1141-1147
© 1993 The Society of Thoracic Surgeons

Articles

Clinical and hemodynamic performance of the 19-mm Carpentier-Edwards porcine bioprosthesis

Robert M. Bojar, MD*, Hassan Rastegar, MD, Douglas D. Payne, MD, Charles A. Mack, MD, Steven L. Schwartz, MD

Departments of Surgery (Cardiothoracic) and Cardiology, New England Medical Center and the Tufts University School of Medicine, Boston, Massachusetts USA

Accepted for publication March 4, 1993.

* Addess reprint requests to Dr Bojar, New England Medical Center, Box 266, 750 Washington St, Boston, MA 02111.

Because of concerns about the hemodynamic performance of 19-mm porcine valves, we retrospectively reviewed the clinical results and echocardiographic studies of 52 consecutive patients who received a 19-mm Carpentier-Edwards porcine bioprosthesis (model 2625) for aortic valve replacement from 1986 through 1991. Nearly 87% of the patients were women, the mean age was 69 years, and the mean body surface area was 1.63 ± 0.27 m2. Seventy-three percent of the patients had pure aortic stenosis, 96% were in New York Heart Association classes III and IV, and 56% underwent urgent or emergent operation. Overall hospital mortality was 7.7% with a late mortality of 8.3% at a mean follow-up of 25 ± 18 months. No patient experienced a valve related complication, and 95% of surviving patients were in New York Heart Association classes I and II. Two-dimensional and Doppler echocardiography performed during the first postoperative week revealed a maximal instantaneous gradient of 44.7 ± 13.0 mm Hg. In 43 patients for whom additional data were available, the mean gradient was 26.4 ± 8.2 mm Hg with an effective orifice area of 0.85 ± 0.18 cm2. This study defines the normal range of postoperative gradients across the 19-mm Carpentier-Edwards porcine valve and demonstrates that patients receiving this valve can achieve significant clinical improvement despite the presence of high transvalvular gradients measured by echocardiography.




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