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Early Doppler-echocardiography evaluation of 597 prosthetic aortic valves

Minardi, Giovanni; Pino, Paolo G; Manzara, Carla C; Pulignano, Giovanni; Viceconte, Giuseppe N; Stefanini, Giulio G; Gaudio, Carlo; Musumeci, Francesco

Journal of Cardiovascular Medicine: April 2010 - Volume 11 - Issue 4 - p 229–233
doi: 10.2459/JCM.0b013e32832ffe4b
Original articles

Objectives: This study was designed to describe the Doppler-echocardiography normal values in the early postoperative phase for Carpentier–Edwards Perimount Aortic Heart Valve bioprosthesis (CEP), St. Jude Medical (SJM) or Medical Regent (SJMR) Mechanical Heart Valves, evaluated by a single experienced echo-laboratory.

Methods: Five hundred and ninety-seven consecutive patients in our hospital, who had had a CEP, a SJM or SJMR-17 mm implanted due to aortic stenosis, underwent a control Doppler-echocardiography evaluation 4–7 days after surgery. Hemodynamic performance of SJM, SJMR and CEP were accurately described, evaluating flow-dependent (trans-prosthetic velocities and gradients) and flow-independent (effective orifice area, indexed effective orifice area and Doppler velocity index) Doppler-echocardiography parameters.

Results: Of the 597 patients 50.6% were women (n = 302). Mean age was 66.3 ± 11.7 years. Mean body surface area (BSA) was 1.76 ± 0.22 m2. Mean ejection fraction was 55.3 ± 10.3%. Two hundred and sixty CEPs and 337 St. Jude mechanical valves (301 SJM and 36 SJMR size-17) were implanted. Comparing size-by-size SJM to CEP, the former were basically less flow obstructive.

Conclusion: Our data confirm the wide range of variability, pointing out the need to perform routinely an accurate baseline Doppler-echocardiography evaluation of the hemodynamic profile of prosthetic aortic valves, including flow-dependent and independent parameters, to allow an adequate interpretation at follow-up.

aDepartment of Cardiovascular Science, ‘S. Camillo-Forlanini’ Hospital, Italy

bHeart and Great Vessels Department ‘Attilio Reale’, Sapienza University of Rome, Rome, Italy

Received 24 March, 2009

Revised 18 June, 2009

Accepted 22 June, 2009

Correspondence to Giovanni Minardi, Department of Cardiovascular Science, ‘S. Camillo-Forlanini’ Hospital, Rome, Italy Tel: +39 06 5870 4701/39 06 5870 4467/39 335 638 5039; e-mail: giovanni.minardi@libero.it

© 2010 Italian Federation of Cardiology. All rights reserved.