title: Clinical and hemodynamic performance of the 19-mm Carpentier-Edwards porcine bioprosthesis.
abstract: Because of concerns about the hemodynamic performance of 19-mm porcine valves, we retrospectively reviewed the clinical results and echocardiographic studies of 52 consecutive patients who received a 19-mm Carpentier-Edwards porcine bioprosthesis (model 2625) for aortic valve replacement from 1986 through 1991. Nearly 87% of the patients were women, the mean age was 69 years, and the mean body surface area was 1.63 +/- 0.27 m2. Seventy-three percent of the patients had pure aortic stenosis, 96% were in New York Heart Association classes III and IV, and 56% underwent urgent or emergent operation. Overall hospital mortality was 7.7% with a late mortality of 8.3% at a mean follow-up of 25 +/- 18 months. No patient experienced a valve-related complication, and 95% of surviving patients were in New York Heart Association classes I and II. Two-dimensional and Doppler echocardiography performed during the first postoperative week revealed a maximal instantaneous gradient of 44.7 +/- 13.0 mm Hg. In 43 patients for whom additional data were available, the mean gradient was 26.4 +/- 8.2 mm Hg with an effective orifice area of 0.85 +/- 0.18 cm2. This study defines the normal range of postoperative gradients across the 19-mm Carpentier-Edwards porcine valve and demonstrates that patients receiving this valve can achieve significant clinical improvement despite the presence of high transvalvular gradients measured by echocardiography.
authors.affiliation: Department of Surgery (Cardiothoracic), New England Medical Center, Boston, MA 02111.
authors.forename: R M
authors.initials: RM
authors.lastname: Bojar
authors.forename: H
authors.initials: H
authors.lastname: Rastegar
authors.forename: D D
authors.initials: DD
authors.lastname: Payne
authors.forename: C A
authors.initials: CA
authors.lastname: Mack
authors.forename: S L
authors.initials: SL
authors.lastname: Schwartz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000502:physiology; D001705:Bioprosthesis; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis / Q000401:mortality; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011182:Postoperative Care; D011183:Postoperative Complications / Q000401:mortality; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors