HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Xu Y. Jin Kumud Dhital Kausik Bhattacharya Ravi Pillai Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Jin, X. Y. Articles by Pillai, R. Search for Related Content PubMed PubMed Citation Articles by Jin, X. Y. Articles by Pillai, R.

Ann Thorac Surg 1998;66:805-809
© 1998 The Society of Thoracic Surgeons

---

Original articles: Cardiovascular

Fifth-year hemodynamic performance of the prima stentless aortic valve

^a Department of Cardiac Surgery, Oxford Heart Centre, John Radcliffe Hospital, Oxford, England, United Kingdom

Accepted for publication April 17, 1998.

Address reprint requests to Mr Pillai, Oxford Heart Centre, John Radcliffe Hospital, Oxford, OX3 9DU, England

Presented in part at the VII International Symposium on Cardiac Bioprostheses, Barcelona, Spain, June 13–16, 1997.

Background. The medium-term hemodynamic performance of stentless valves has not been widely reported, particularly in comparison with in vitro studies. Therefore, we have assessed prospectively the hemodynamics of the Edwards Prima valve in its fifth year after implantation in the aortic position, and compared the results with those at 1 month after implantation and also with in vitro data.

Methods. Thirty-five patients (age, 77 ± 6 years; 19 men) were prospectively studied by Doppler echocardiography at 1 month and 52 ± 8 months after implantation of a Prima stentless valve. Valve hemodynamics were assessed by measuring the mean pressure gradient, mean valve resistance, and effective orifice area. Left ventricular systolic function was quantified by ejection fraction, the degree of hypertrophy by ventricular mass index, and the ratio of ventricular wall thickness to cavity radius as a measure of ventricular geometry.

Results. With a mean valve size of 24.6 ± 2.2 mm in the fifth year after implantation, the mean pressure gradient was 6.2 ± 3.5 mm Hg, the mean valve resistance, 29 ± 16 dyne · s^-1 · cm^-5), and the effective orifice area was 2.05 ± 0.50 cm². Compared with 1 month after operation, there was a 47% decrease in mean valve resistance (p = 0.002) and a 39% increase in effective orifice area (p = 0.001). Furthermore, both effective orifice area and mean valve resistance in the fifth year did not differ from their in vitro counterparts, whereas the left ventricular ejection fraction (0.64 ± 0.14), the left ventricular mass index (119 ± 49 g/m²), and the ratio of ventricular wall thickness to cavity radius (0.44 ± 0.13) were within the normal range.

Conclusions. This study suggests that the Prima valve is a reliable stentless aortic bioprosthesis. This is supported by a favorable medium-term clinical outcome, durable hemodynamic performance, and normal mean values of left ventricular ejection fraction and mass index in the fifth year after implantation.

This article has been cited by other articles:

				X. Y. Jin and C. Ratnatunga Invited commentary Ann. Thorac. Surg., July 1, 2007; 84(1): 78 - 79. [Full Text] [PDF]

				P. Totaro, N. Degno, A. Zaidi, A. Youhana, and V. Argano Carpentier-Edwards PERIMOUNT Magna bioprosthesis: A stented valve with stentless performance? J. Thorac. Cardiovasc. Surg., December 1, 2005; 130(6): 1668 - 1674. [Abstract] [Full Text] [PDF]

				F. J. Schoen and R. F. Padera Jr. Cardiac Surgical Pathology Card. Surg. Adult, January 1, 2003; 2(2003): 119 - 185. [Full Text]

				D. B. Doty and J. R. Doty Stentless Aortic Valve Replacement: Bioprostheses Card. Surg. Adult, January 1, 2003; 2(2003): 889 - 898. [Full Text]

				A. D. Milano, C. Blanzola, G. Mecozzi, A. D'Alfonso, M. De Carlo, C. Nardi, and U. Bortolotti Hemodynamic performance of stented and stentless aortic bioprostheses Ann. Thorac. Surg., July 1, 2001; 72(1): 33 - 38. [Abstract] [Full Text] [PDF]

				K. L. Yun, C. F. Sintek, A. D. Fletcher, T. A. Pfeffer, G. S. Kochamba, M. R. Hyde, J. O. Torpoco, and S. Khonsari Aortic Valve Replacement With the Freestyle Stentless Bioprosthesis : Five-Year Experience Circulation, November 9, 1999; 100 (2009): II-17 - II-23. [Abstract] [Full Text] [PDF]

				X. Y. Jin, R. Pillai, and S. Westaby Medium-term determinants of left ventricular mass index after stentless aortic valve replacement Ann. Thorac. Surg., February 1, 1999; 67(2): 411 - 416. [Abstract] [Full Text] [PDF]