Relation between size of prosthesis and valve gradient: comparison of two aortic bioprosthesis

Seitelberger, Rainald; Bialy, Jan; Gottardi, Roman; Seebacher, Gernot; Moidl, Reinhard; Mittelböck, Martina; Simon, Paul; Wolner, Ernst

doi:10.1016/j.ejcts.2003.12.011

Cited by 36 publications

(25 citation statements)

References 15 publications

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“…Seitelberger et al reported that in their prospective randomized study, the labeled valve size was smaller compared with the aortic diameter in the Perimount group than in the Mosaic group, and that the hemodynamic performance was similar for these 2 prostheses when the aortic diameter was used as the reference. 17 In the present study, the postoperative mean transvalvular PG was 13-19 mmHg, and decreased with prosthesis size. Follow-up echocardiography showed a slight increase in PG associated with each increase in valve size, which may be explained by increased cardiac output in the late period.…”

Section: Study Limitationssupporting

confidence: 52%

Hemodynamic Performance and Durability of Mosaic Bioprostheses for Aortic Valve Replacement, up to 13 Years

Matsumoto

Fujita

Hata

et al. 2015

Circ J

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Section: Study Limitationssupporting

confidence: 52%

Hemodynamic Performance and Durability of Mosaic Bioprostheses for Aortic Valve Replacement, up to 13 Years

Matsumoto

Fujita

Hata

et al. 2015

Circ J

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“…Pressure gradients of the Magna, the Mosaic, and the Soprano are in accord with findings of other groups. 1,[3][4][5][6]8,13,14,20,22,[25][26][27][28][29][30][31] There are preliminary in vivo hemodynamic data available regarding the Mosaic Ultra 10 and only 1 in vivo evaluation of the Epic, which was published previously by our group. 4 The in vitro data concerning hemodynamic gradients of the Epic and the Ultra correspond well with our results.…”

Section: Mean Pressure Gradientsmentioning

confidence: 99%

The Complete Supraannular Concept

et al. 2009

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Background— Complete supraannular placement of an aortic bioprosthesis is one approach to optimize the hemodynamic result of an aortic valve replacement. It is achieved with the combination of a special valve design and the supraannular sewing technique with noneverted mattress sutures. We evaluated 5 bioprostheses designed for complete supraannular placement to assess potential hemodynamic differences caused by factors (eg, valve material) other than implantation position. Methods and Results— In 336 patients (mean age, 72.0±7.1 years; 143 women), hemodynamics including mean pressure gradients, effective orifice areas, and indices and incidence of patient-prosthesis mismatch were evaluated 6 months after surgery. Annulus diameter was measured during surgery. Patients received the Carpentier Edwards Perimount Magna (Magna, n=169), the Medtronic Mosaic (Mosaic, n=46), the Mosaic Ultra (Ultra, n=17), the SJM Epic Supra (Epic, n=46), and the Sorin Soprano (Soprano, n=58). For small annulus sizes (<23 mm), the mean pressure gradients of the Magna (11.82±4.8 mm Hg) were significantly lower than the Mosaic (16.04±6.1 mm Hg) and the Ultra (22.0±4.1 mm Hg), and the Soprano (13.3±5.2 mm Hg) was hemodynamically superior to the Ultra. For medium (23 to 24 mm) and large (>24 mm) annulus sizes, the mean pressure gradients of the Magna were lower than the Epic (10.0±3.5 mm Hg versus 14.9±6.4 mm Hg; 9.9±4.0 mm Hg versus 18.6±12.7 mm Hg). Furthermore, in patients with large annulus size, the mean pressure gradients of the Soprano (11.4±3.8 mm Hg) were lower compared with the Epic (18.5±12.7 mm Hg). Severe patient-prosthesis mismatch was observed more frequently in patients with the Mosaic (12/46; 26.1%) and the Ultra (3/17; 17.6%) prostheses. Conclusions— Complete supraannular placement cannot prevent high pressure gradients or patient-prosthesis mismatch thoroughly, but the choice of a bovine prosthesis can optimize hemodynamic performance.

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“…Studies comparing CEP to Medtronic Mosaic valves demonstrated smaller metric diameters for the Mosaic valve leading to the ability to implant larger valve sizes in 28.4% for the porcine valve versus only in 8.3% in the pericardial valves [17]. Some of the results might have been influenced by the differences in inner valve diameter, because the leaflets were subjected to different mechanical stress.…”

Section: Discussionmentioning

confidence: 97%

“…This in vitro method of calcification uses Ca-phosphate at a pH value of 7.4 and physiological temperature of 37 8C. This method has been used and investigated previously, demonstrating results comparable to in vivo valve degeneration [11,12,22]. The higher pulse rate accelerates the calcification process as additional mechanical stress is applied to the leaflets.…”

Section: Valve Calcificationmentioning

confidence: 95%

Hydrodynamic comparison of biological prostheses during progressive valve calcification in a simulated exercise situation. An in vitro study

Bakhtiary

Dzemali

Steinseiffer

et al. 2008

European Journal of Cardio-Thoracic Surgery

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In the exercise situation pericardial valves demonstrated superior systolic function compared to porcine valves. Therefore pericardial valves have some advantage in active patients due to the lower gradients. Total energy loss remained constant during progressive calcification for both valves. Leaflet opening and closing is faster in porcine valves; clinical impact of these findings is not known. Diastolic performance is also important and should always be tested also in vivo.

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Relation between size of prosthesis and valve gradient: comparison of two aortic bioprosthesis

Cited by 36 publications

References 15 publications

Hemodynamic Performance and Durability of Mosaic Bioprostheses for Aortic Valve Replacement, up to 13 Years

Hemodynamic Performance and Durability of Mosaic Bioprostheses for Aortic Valve Replacement, up to 13 Years

The Complete Supraannular Concept

Hydrodynamic comparison of biological prostheses during progressive valve calcification in a simulated exercise situation. An in vitro study

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