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Hemodynamic performance of the Edwards Prima Plus stentless valve at 1 year

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Abstract

Purpose

The Edwards Prima Plus stentless valve bioprosthesis (EPPSV) is a porcine aortic root cylinder with resected coronary ostia, fixed in glutaraldehyde at low pressure, and chemically treated to prevent calcification. Utilization of this valve was approved in January 2005 in Japan. The purpose of this study was to evaluate the early hemodynamic performance of EPPSVs in our experience.

Materials and methods

From April 2005 to January 2006, a total of 21 patients underwent aortic valve replacement with EPPSVs. The hemodynamic performance of EPPSVs was evaluated at the time of discharge (2 weeks) and at 1 year by transthoracic two-dimensional Doppler echocardiography.

Results

There was one non-valve-related early death and one non-valve-related late death. Hemodynamic data were available for comparison from the time of discharge and at 1 year postoperatively in 19 patients (mean valve size 22 ± 1 mm). Hemodynamic follow-up showed a significant decrease in the peak and mean transvalvular pressure gradients at discharge (37 ± 16 and 18 ± 8 mmHg, respectively) and 1 year postoperatively (25 ± 7 and 12 ± 4 mmHg, respectively) (P < 0.01). The effective orifice area increased significantly between the time of discharge (1.31 ± 0.31 cm2) and 1 year (1.57 ± 0.37 cm2) (P < 0.05) postoperatively. The left ventricular mass index was significantly reduced from the time of discharge (167 ± 49 g/m2) to 1 year postoperatively (126 ± 47 g/m2) (P < 0.001).

Conclusion

EPPSVs have been associated with high early transprosthetic gradients. Such gradients tend to regress, with significant improvement at 1 year and concomitant regression of left ventricular hypertrophy.

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References

  1. Sahn DJ, Demaria A, Kisslo J, Weyman A. The committee on M-mode standardization of American Society of Echocardiography: recommendations regarding quantification in M-mode echocardiography—results of a survey of echocardiographic measurements. Circulation 1978;58:1072–1083.

    PubMed  CAS  Google Scholar 

  2. Binet JP, Duran CG, Carpentier A, Langlois J. Heterologous aortic valve transplantation. Lancet 1965;2:1275.

    Article  PubMed  CAS  Google Scholar 

  3. Bortolotti U, Milano A, Mussuto E, Mazzaro E, Thiene G, Casarotto D. Porcine valve durability: a comparison between Hancock standard and Hancock II bioprostheses. Ann Thorac Surg 1995;60:S216–S220.

    Article  PubMed  CAS  Google Scholar 

  4. Ius P, Totis O, Chirillo F, Cavarzerani A, Zussa C, Piccoli C, et al. Hemodynamic evaluation of 23-mm Pericarbon and 23-mm Hancock II bioprosthesis in the aortic position at midterm follow-up. J Heart Valve Dis 1996;5:656–661.

    PubMed  CAS  Google Scholar 

  5. Walther T, Falk V, Langebartels G, Kruger M, Bernhardt U, Diegeler A, et al. Prospectively randomized evaluation of stentless versus conventional biological aortic valves: impact on early left ventricular hypertrophy. Circulation 1999;100:II6–II10.

    PubMed  CAS  Google Scholar 

  6. Borger MA, Carson SM, Ivavov J, Rao V, Scully HE, Feindel CM, et al. Stentless aortic valves are hemodynamically superior to stented valves during mid-term follow-up: a large retrospective study. Ann Thorac Surg 2005;80:2180–2185.

    Article  PubMed  Google Scholar 

  7. David TE, Pollick C, Bos J. Aortic valve replacement with stentless porcine aortic bioprosthesis. J Thorac Cardiovasc Surg 1990;99:113–118.

    PubMed  CAS  Google Scholar 

  8. Pillai R, Spriggins D, Amarasena N, O’Reagan DJ, Parry AJ, Westaby S. Stentless bioprosthesis? The way forward: early experience with the Edwards valve. Ann Thorac Surg 1993; 56:88–91.

    Article  PubMed  CAS  Google Scholar 

  9. Bortolotti U, Milano A, Tartarini G, Scioti G, Borzoni G, Nardi C, et al. Hemodynamic performance of the Edwards Prima Stentless valve. J Heart Valve Dis 1997;6:134–137.

    PubMed  CAS  Google Scholar 

  10. Parry GW, Batrick NC, Shabbo FP. Early valve hemodynamics following implantation of the Edwards Prima stentless aortic bioprosthesis. In: Piwnica A, Westaby S, editors. Stentless bioprostheses. Oxford: Isis Medical Media; 1995. p. 1633–1639.

    Google Scholar 

  11. Bortolotti U, Scioti G, Milano A, Borzoni G, Nardi C, Tartarini G. The Edwards Prima stentless valve: hemodynamic performance at one year. Ann Thorac Surg 1999;68:2147–2151.

    Article  PubMed  CAS  Google Scholar 

  12. Albert A, Florath I, Rosendahl U, Hassanein W, Hodenberg EV, Bauer S, et al. Effect of surgeon on transprosthetic gradients after aortic valve replacement with Freestyle® stentless bioprosthesis and its consequences: a follow-up study in 587 patients. J Cardiothorac Surg 2007;2:40.

    Article  PubMed  Google Scholar 

  13. Westaby S, Jönson A, Payne N, Saito S, Jin XY, Del Rizzo DF, et al. Dose the use of a stentless bioprosthesis increase surgical risk? Semin Thorac Cardiovasc Surg 2001; 13(suppl 1):143–147.

    PubMed  CAS  Google Scholar 

  14. Dossche K, Vanermen H. Experience with the Edwards Prima stentless aortic bioprosthesis: a 2-year review. J Heart Valve Dis 1995;4(suppl I):S85–S89.

    PubMed  Google Scholar 

  15. Westaby S, Amarasena N, Long V, Prothero A, Amarasena GA, Banning AP, et al. Time-related hemodynamic changes after aortic replacement with the Freestyle stentless xenograft. Ann Thorac Surg 1995;60:1633–1639.

    Article  PubMed  CAS  Google Scholar 

  16. Ali A, Halstead JC, Cafferty F, Sharples L, Rose F, Coulden R, et al. Are stentless valves superior to modern stented valves? A prospective randomized trial. Circulation 2006;114(suppl I):535–540.

    Google Scholar 

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Correspondence to Keizo Tanaka.

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Tanaka, K., Kinoshita, T., Fujinaga, K. et al. Hemodynamic performance of the Edwards Prima Plus stentless valve at 1 year. Gen Thorac Cardiovasc Surg 56, 441–445 (2008). https://doi.org/10.1007/s11748-008-0286-z

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  • DOI: https://doi.org/10.1007/s11748-008-0286-z

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