title: [Doppler echocardiography evaluation of the hemodynamic performance of the Lillehei-Kaster and Medtronic Hall valves in aortic position].
abstract: OBJECTIVE
  To establish the range of normal values by Doppler echocardiography of the parameters inherent to the hemodynamic performance of the Lillehei-Kaster (LK) and Medtronic Hall (MH) prosthetic valves (V), in the 23 mm (LKV-16, MHV-23) and 25 mm (LKV-18, MHV-25) outer diameter valves, in the aortic position.
  
  
  METHODS
  Doppler echocardiography was performed in 32 asymptomatic patients, with normally functioning prosthetic aortic valves (8 of each type).
  
  
  RESULTS
  The peak velocity of aortic jet was 3.13 +/- 0.46 m/sec for the LKV-16, 2.76 +/- 0.31 m/sec for the MHV-23, 2.82 +/- 0.48 m/sec for the LKV-18 and 2.43 +/- 0.36 m/sec for the MHV-25. The maximal pressure gradient was 39.84 +/- 12.05 mmHg for the LKV-16, 30.70 +/- 6.80 mmHg for the MHV-23, 32.60 +/- 10.75 mmHg for the LKV-18 and 24.11 +/- 6.70 mmHg for the MHV-25. The mean pressure gradient was 24.25 +/- 7.09 mmHg for the LKV-16, 18.50 +/- 4.41 mmHg for the MHV-23, 18.21 +/- 6.95 mmHg for the LKV-18 and 13.57 +/- 4.17 mmHg for the MHV-25. The valve effective orifice area, considering the left ventricle outflow area determined by two-dimensional echocardiography in the continuity equation, was 0.62 +/- 0.13 cm2 for the LKV-16, 1.05 +/- 0.21 cm2 for the MHV-23, 0.98 +/- 0.22 cm2 for the LKV-18 and 1.36 +/- 0.36 cm2 for the MHV-25. Considering the left ventricle outflow area equivalent to the valve sewing ring area, the valve effective orifice area was 1.40 +/- 0.23 cm2 for the LKV-16, 1.65 +/- 0.19 cm2 for the MHV-23, 1.91 +/- 0.43 cm2 for the LKV-18 and 2.37 +/- 0.56 cm2 for the MHV-25. The Doppler velocity index was 0.34 +/- 0.05 for the LKV-16, 0.40 +/- 0.04 for the MHV-23, 0.39 +/- 0.09 for the LKV-18 and 0.49 +/- 0.11 for the MHV-25.
  
  
  CONCLUSIONS
  Significant hemodynamic performance superiority of the MHV over the LKV was registered, indicating that the small LKV (LKV-16 or smaller) should be avoided.
authors.affiliation: Escola Paulista de Medicina, Jaboatão, PE.
authors.forename: C F
authors.initials: CF
authors.lastname: Kirzner
authors.forename: O
authors.initials: O
authors.lastname: Campos Filho
authors.forename: E
authors.initials: E
authors.lastname: Buffolo
mesh_terms: D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000503:physiopathology / Q000648:ultrastructure; D015150:Echocardiography, Doppler; D005260:Female; D006350:Heart Valve Prosthesis; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D013923:Thromboembolism / Q000601:surgery
vernacular_title: Avaliação Doppler-ecocardiográfica do desempenho hemodinâmico das válvulas Lillehei-Kaster e Medtronic Hall em Posição Aórtica.