Early Doppler-echocardiography evaluation of 597 prosthetic aortic valves

Abstract

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. 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. 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 m. 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. 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.