Evaluation of hemodynamics after mitral valve replacement with the St Jude Medical Epic bioprosthesis: a Japanese single-center experience.

Abstract

To assess the early hemodynamics after mitral valve replacement (MVR) using the St Jude Medical (SJM) Epic bioprosthesis. MVR was performed using the SJM Epic bioprosthesis in 35 patients from June 2018 to April 2020; three patients were excluded because the postoperative transthoracic echocardiography (TTE) data were unavailable. Data from postoperative TTE at 1week and 3months after the procedure were reviewed. The mean mitral pressure gradient (mMPG) was calculated using a continuous wave Doppler method. Left ventricular outflow tract (LVOT) was calculated using a pulse wave Doppler method. The effective orifice area (EOA) was measured from pressure half time. There were 12 men (37.5%) and 20 women (62.5%) with a mean age of 75.9years (61-88years). The mean body surface area was 1.51 ± 0.22cm2. The 25mm and 27mm valves were used in more than 50% of cases. The mMPG was 4.9 ± 1.7mmHg and 5.4 ± 1.6mmHg at 1week and 3months after surgery, respectively. EOA was 2.18 ± 0.50cm2 and 2.31 ± 0.59cm2 at 1week and 3months after surgery, respectively. The peak velocity of the LVOT (n = 22) was 103.3 ± 21.3cm/s and 106.8 ± 27.4cm/s at 1week and 3months after surgery, respectively. No findings suggested paravalvular regurgitation and LVOT obstruction. Using the SJM Epic bioprosthesis in MVR resulted in satisfactory hemodynamics in the early postoperative period, even with small valve sizes. Further accumulation of cases and evidence, including mid- to long-term results, is required in the future.