The Hemodynamic Performance of Carpentier-Edwards PERIMOUNT Magna for Aortic Valve Stenosis
10.4326/jjcvs.40.81
- VernacularTitle:AS に対する AVR における CEP Magna の術後早期弁機能
- Author:
Daisuke Takahashi
;
Mitsuomi Shimamoto
;
Fumio Yamazaki
;
Masanao Nakai
;
Yujiro Miura
;
Tatsuya Itonaga
;
Tatsuji Okada
;
Ryota Nomura
;
Noriyuki Abe
;
Yasuhiko Terai
- Publication Type:Journal Article
- Keywords:
aortic valve replacement;
bioprosthesis;
patient-prosthesis mismatch;
effective orifice area;
aortic valve stenosis
- From:Japanese Journal of Cardiovascular Surgery
2011;40(3):81-85
- CountryJapan
- Language:Japanese
-
Abstract:
This study compared the hemodynamic performance of the Carpentier-Edwards PERIMOUNT Magna bioprosthesis (Magna) with the Carpentier-Edwards PERIMOUNT bioprosthesis (CEP) for aortic valve stenosis (AS). Between January 2005 and May 2010, 164 patients underwent aortic valve replacement for AS with either the Magna (n=68) or the CEP (n=96) at our institute. Patients undergoing a concomitant mitral valve procedure were excluded from this study. The 21-mm Magna and CEP prostheses were the most frequently used during this period. Transthoracic echocardiography was postoperatively performed within 2 weeks. The peak velocity (PV) of the Magna was significantly lower than that of the CEP (2.59±0.36 vs. 2.75±0.47 m/s ; p=0.022). The mean pressure gradient (PG) was not significantly different. For the 19-mm prostheses, the mean PG and PV of the Magna were significantly lower than those of the CEP [16.4±4.5 vs. 19.7±6.4 mmHg ; p=0.034 (PG) and 2.70±0.36 vs. 3.03±0.49 m/s ; p=0.008 (PV)]. The effective orifice area (EOA) of the Magna was larger than that of the CEP [19 mm : 1.29±0.18 vs. 1.11±0.24 cm2 (p=0.007) ; 21 mm : 1.46±0.23 vs. 1.42±0.18 cm2 (p=0.370) ; and 23 mm : 1.70±0.34 vs. 1.52±0.25 cm2 (p=0.134)]. In this study, the EOA of the Magna was approximately 80% of that described in the manufacture's description. Patient-prosthesis mismatch (PPM ; EOA index≤0.85 cm2/m2) was seen in 26.8% of patients with the Magna and in 47.2% of patients with the CEP (p=0.018). Severe PPM (EOA index≤0.65 cm2/m2) was not seen in any patients with the Magna. The EOA of the 19-mm Magna was significantly larger and the mean PG was lower than those of the 19-mm CEP. Compared with the CEP, the Magna significantly reduced the incidence of PPM, and had superior hemodynamic performance.
