Document Detail


Serial Doppler echocardiographic evaluation of small-sized sorin bicarbon prostheses.
MedLine Citation:
PMID:  12928629     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The Sorin Bicarbon prosthesis (Sorin Biomedica, Saluggia, Italy) is a bileaflet valve with curved-profile leaflets, a rolling hinge mechanism, and a pyrolytic carbon-coated titanium alloy housing and sewing ring. Although the Sorin Bicarbon prosthesis has been implanted in greater than 80,000 patients, and reference values on the hemodynamic performance of valve prostheses are needed to avoid patient-prosthesis mismatch, few Doppler echocardiographic data are available on the prosthesis in the aortic position. The aim of this study is to provide a detailed echocardiographic evaluation of the hemodynamic performance and regression of left ventricular hypertrophy after aortic valve replacement with the Sorin Bicarbon prosthesis. METHODS: The study included 182 patients who received a 21-mm (n = 61) or 23-mm (n = 121) Sorin Bicarbon prosthesis for pure or prevalent aortic stenosis who underwent serial echocardiograms at 3, 6, and 12 months after aortic valve replacement. RESULTS: Mean and peak gradients significantly decreased (P <.001) during follow-up to values of 12 +/- 3 and 22 +/- 6 mm Hg for the 21-mm prosthesis and values of 11 +/- 4 and 19 +/- 6 mm Hg for the 23-mm prosthesis at 1 year. Left ventricular mass index showed a 17% decrease to 120 +/- 27 g/m(2) in recipients of the 21-mm prosthesis (P <.001) and a 21% decrease to 123 +/- 29 g/m(2) in recipients of the 23-mm prosthesis (P <.001). A larger prosthesis size was the only predictor of a higher left ventricular mass index regression. Among recipients of the 21-mm prosthesis, body surface area of greater than 1.85 m(2) was associated with a lower regression of left ventricular mass index. The effective orifice area index was 1.00 +/- 0.11 and 1.08 +/- 0.14 cm(2)/m(2) in recipients of the 21-mm and 23-mm prostheses, respectively. CONCLUSIONS: Size 21 mm and 23 mm Sorin Bicarbon prostheses show low transprosthetic gradients, with significant reduction of left ventricular mass index during the first postoperative year. The reported effective orifice areas might be useful for aortic valve replacement in patients with a small aortic annulus to avoid patient-prosthesis mismatch.
Authors:
Marco De Carlo; Aldo D Milano; Carmela Nardi; Gianclaudio Mecozzi; Uberto Bortolotti
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  126     ISSN:  0022-5223     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-08-20     Completed Date:  2003-10-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  337-43     Citation Subset:  AIM; IM    
Affiliation:
Cardiothoracic Department, University of Pisa Medical School, 56124 Pisa, Italy.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aortic Valve Stenosis / physiopathology,  surgery*,  ultrasonography*
Blood Pressure / physiology
Body Surface Area
Echocardiography, Doppler, Color*
Female
Follow-Up Studies
Heart Valve Prosthesis*
Heart Valve Prosthesis Implantation / instrumentation
Humans
Hypertrophy, Left Ventricular / physiopathology,  surgery,  ultrasonography
Italy
Male
Middle Aged
Postoperative Complications / etiology,  physiopathology,  ultrasonography
Prosthesis Design
Regression Analysis
Stroke Volume / physiology
Systole / physiology
Time Factors
Treatment Outcome
Comments/Corrections
Comment In:
J Thorac Cardiovasc Surg. 2003 Aug;126(2):313-6   [PMID:  12928620 ]
J Thorac Cardiovasc Surg. 2003 Aug;126(2):317-20   [PMID:  12928621 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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