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Ann Thorac Surg 2001;71:S282-S284
© 2001 The Society of Thoracic Surgeons
a Division of Cardiovascular Surgery, Department of Surgery, University of British Columbia, British Columbia, Vancouver, Canada
Address reprint requests to Dr Jamieson, St. Paul’s Hospital, 331-332 Burrard Building, 1081 Burrard St, Vancouver, BC V6Z 1Y6, Canada
e-mail: wrej{at}interchange.ubc.ca
Presented at the VIII International Symposium on Cardiac Bioprostheses, Cancun, Mexico, Nov 3–5, 2000.
Background. The hemodynamic performance of aortic replacement prostheses is of extreme importance. There is renewed interest in hemodynamics because of the influence of prosthesis–patient mismatch on left ventricular mass regression and the potential influence on survival.
Methods. The hemodynamic performance of the second-generation Carpentier-Edwards supraannular porcine and pericardial (Perimount) bioprostheses and the third-generation Medtronic Mosaic porcine bioprosthesis were compared for mean gradient and effective orifice area index. The effective orifice area index of at least 0.85 cm2/M2 was considered as lack of prosthesis–patient mismatch. The study group included included 53 patients with Carpentier-Edwards supraannular porcine, 48 with pericardial, and 98 with Medtronic Mosaic porcine bioprostheses.
Results. The mean gradients were not different between the prostheses by prosthesis size. The Medtronic Mosaic was not provided in size 19. The mean gradients for the prostheses, except in the very large sizes, were all double-digit values. The effective orifice area index was not different between the prostheses but there was a trend toward prosthesis-patient mismatch in smaller size prostheses.
Conclusions. There was no apparent hemodynamic advantage between porcine and pericardial bioprostheses in the aortic position.
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