Document Detail


Haemodynamic performance of aortic pericardial bioprostheses and bileaflet prostheses at rest and during exercise: implications for the surgical management of patients with small aortic roots.
MedLine Citation:
PMID:  10409527     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the haemodynamic behaviour, at rest and during exercise, of aortic valve pericardial bioprostheses and different sizes of bileaflet prosthesis. DESIGN: Observational study. SETTING: Tertiary medical centre. PATIENTS AND INTERVENTIONS: 74 patients (33 women, 41 men; mean age 64 years) in whom 40 pericardial bioprostheses and 34 bileaflet prostheses sized 19, 21, or 23 mm had been implanted to replace aortic valves. MAIN OUTCOME MEASURES: Doppler echocardiography at rest and at peak exercise, between 12 and 47 months after surgery. RESULTS: All patients achieved a significant increase in heart rate, systolic blood pressure, and cardiac output with exercise. Transvalvar pressure fall, valve area, and left ventricular systolic and diastolic function indices also underwent significant changes with exercise. Reductions in peak and mean transvalvar pressure, at rest and at peak exercise, were greater in patients with small valves (p < 0.05). Valve areas and effective area index were greater in the patients with larger valves (p < 0.001). There were no significant differences between patients with mechanical and biological prostheses with regard to transvalvar pressure fall and valve areas at rest and at peak exercise. CONCLUSIONS: 19 mm and 21 mm aortic prostheses and bioprostheses continue to create significant obstruction, particularly with exercise.
Authors:
J R González-Juanatey; M V Fernández; F G Sampedro; J M García-Acuña; J B García-Bengoechea; A A Cendon; M G de La Peña
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  82     ISSN:  1355-6037     ISO Abbreviation:  Heart     Publication Date:  1999 Aug 
Date Detail:
Created Date:  1999-08-26     Completed Date:  1999-08-26     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  149-55     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Galician General Hospital and University of Santiago Faculty of Medicine, 15705 Santiago de Compostela, Spain. gonzalezd@meditex.es
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MeSH Terms
Descriptor/Qualifier:
Aged
Aortic Valve / surgery*,  ultrasonography
Aortic Valve Stenosis / physiopathology,  surgery*,  ultrasonography
Bioprosthesis
Blood Pressure
Cardiac Output
Echocardiography, Doppler
Exercise Test
Female
Heart Rate
Heart Valve Prosthesis*
Hemodynamics
Humans
Male
Middle Aged
Postoperative Period
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