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Ann Thorac Surg 2001;71:609-613
© 2001 The Society of Thoracic Surgeons

Original article: cardiovascular

Hemodynamic evaluation of 19-mm Carpentier-Edwards pericardial bioprosthesis in aortic position

Hiromitsu Takakura, MDa, Tatsuumi Sasaki, MDa, Kazuhiro Hashimoto, MDa, Takashi Hachiya, MDa, Katsuhisa Onoguchi, MDa, Motohiro Oshiumi, MDa, Shigeyuki Takeuchi, MDa

a Department of Cardiovascular Surgery, Saitama Cardiovascular and Respiratory Center, Saitama, Japan

Accepted for publication July 15, 2000.

Address reprint requests to Dr Takakura, 1696 Itai, Konan-machi, Osato-gun, Saitama 360-0105, Japan
e-mail: idabagus{at}yj8.so-net.ne.jp

Background. The aortic Carpentier-Edwards pericardial bioprosthesis offers good long-term clinical outcomes with a low rate of structural deterioration. However, little in vivo hemodynamic data is available for this bioprosthesis.

Methods. To determine the hemodynamic performance of the 19-mm Carpentier-Edwards pericardial valve, both cardiac catheterization and dobutamine stress echocardiography were electively performed in 10 patients. The mean age at the study was 71.6 ± 4.4 years and the mean body surface area was 1.39 ± 0.11 m2. The peak-to-peak gradient, instantaneous peak gradient, mean gradient, and valve orifice area were measured by standard cardiac catheterization. The Doppler-derived gradients and valve orifice area were also measured both at rest and during dobutamine infusion.

Results. The average peak-to-peak gradient, instantaneous peak gradient, mean gradient, and valve orifice area measured by catheterization were 13.0 ± 5.4 mmHg, 28.5 ± 7.7 mmHg, 12.0 ± 4.9 mmHg, and 1.55 ± 0.45 cm2, respectively. The peak and mean Doppler gradients, and valve orifice area by resting echocardiography were 27.7 ± 9.5 mmHg, 12.3 ± 4.8 mmHg, and 1.39 ± 0.26 cm2, respectively. At a dosage of 10 µg/kg/min of dobutamine, the mean Doppler gradient rose mildly to 22.2 ± 4.8 mmHg, while the cardiac output increased from 4.49 ± 0.44 to 6.64 ± 0.87 L/min. The valve orifice area during the 10 µg/kg/min dobutamine infusion (1.55 ± 0.25 cm2) was significantly larger than its value at rest (p < 0.05).

Conclusions. With acceptable hemodynamic performance, use of the aortic 19-mm Carpentier-Edwards pericardial valve is a reliable option for elderly patients with a small annulus.




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