Hemodynamic characterization of the CarboMedics mitral valve prosthesis.
OBJECTIVE
The hemodynamic function of the CarboMedics bileaflet mitral valve prosthesis was evaluated by Doppler echocardiography and by heart catheterization. The clinical state of the invasively examined patients was evaluated before and after surgery.


METHODS
Doppler echocardiography was performed in 54 patients at six months after surgery. Further, combined right and left heart catheterization was performed in 22 of these patients before surgery and at six months thereafter.


RESULTS
The Doppler mean gradients were small (3.6 +/- 1.2 mmHg), and corresponded well with Doppler mean gradients in the subgroup examined with both methods (3.5 +/- 1.1 mmHg) and with the invasive gradients (3.4 +/- 1.9 mmHg); there was also no difference between the different valve sizes. Clinically, pressure recovery distal to the valve is probably so small that no systematic difference between the two techniques of measurement is present. Only physiological regurgitation was found, and no case of valve dysfunction. The patients improved from functional NYHA class 3.1 +/- 0.4 to 1.4 +/- 0.6, regardless of preoperative diagnosis, with most pronounced improvement in those with mitral stenosis. Pulmonary artery pressure was normalized. Pulmonary vascular resistance and cardiac index improved slightly.


CONCLUSIONS
In conclusion, the valvular prostheses demonstrated excellent hemodynamic function. There was striking agreement between the small invasive and non-invasive gradients. Finally, the functional status of the patients improved considerably, most distinctly in those patients with prior mitral stenosis.
Bjørnerheim
R
R
Department of Medicine, Rikshospitalet, University of Oslo, Norway.
Ihlen
H
H
Simonsen
S
S
Sire
S
S
Svennevig
J
J
D000328:Adult; D000368:Aged; D001705:Bioprosthesis; D001783:Blood Flow Velocity; D006328:Cardiac Catheterization; D015150:Echocardiography, Doppler; D004869:Equipment Safety; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery*; D006350:Heart Valve Prosthesis / Q000295:instrumentation* / Q000379:methods; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016896:Treatment Outcome