Hemodynamic performance of the Edwards Prima Plus stentless valve at 1 year.
OBJECTIVE
The Edwards Prima Plus stentless valve bioprosthesis (EPPSV) is a porcine aortic root cylinder with resected coronary ostia, fixed in glutaraldehyde at low pressure, and chemically treated to prevent calcification. Utilization of this valve was approved in January 2005 in Japan. The purpose of this study was to evaluate the early hemodynamic performance of EPPSVs in our experience.


METHODS
From April 2005 to January 2006, a total of 21 patients underwent aortic valve replacement with EPPSVs. The hemodynamic performance of EPPSVs was evaluated at the time of discharge (2 weeks) and at 1 year by transthoracic two-dimensional Doppler echocardiography.


RESULTS
There was one non-valve-related early death and one non-valve-related late death. Hemodynamic data were available for comparison from the time of discharge and at 1 year postoperatively in 19 patients (mean valve size 22 +/- 1 mm). Hemodynamic follow-up showed a significant decrease in the peak and mean transvalvular pressure gradients at discharge (37 +/- 16 and 18 +/- 8 mmHg, respectively) and 1 year postoperatively (25 +/- 7 and 12 +/- 4 mmHg, respectively) (P < 0.01). The effective orifice area increased significantly between the time of discharge (1.31 +/- 0.31 cm2) and 1 year (1.57 +/- 0.37 cm2) (P < 0.05) postoperatively. The left ventricular mass index was significantly reduced from the time of discharge (167 +/- 49 g/m2) to 1 year postoperatively (126 +/- 47 g/m2) (P < 0.001).


CONCLUSIONS
EPPSVs have been associated with high early transprosthetic gradients. Such gradients tend to regress, with significant improvement at 1 year and concomitant regression of left ventricular hypertrophy.
Tanaka
Keizo
K
Department of Thoracic and Cardiovascular Surgery, Anjo Kosei Hospital, 28 Higashihirokute Anjo-cho, Anjo, Aichi 446-8602, Japan. keizo-5254r@yahoo.co.jp
Kinoshita
Toshihiko
T
Fujinaga
Kazuya
K
Kanemitsu
Shinji
S
Tanaka
Jin
J
Suzuki
Hitoshi
H
Tokui
Toshiya
T
D000368:Aged; D000818:Animals; D001024:Aortic Valve Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001705:Bioprosthesis; D018618:Echocardiography, Doppler, Color; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation*; D006439:Hemodynamics; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D008297:Male; D011474:Prosthesis Design; D013318:Stroke Volume; D013552:Swine; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left
Circulation. 1999 Nov 9;100(19 Suppl):II6-10
10567271
Lancet. 1965 Dec 18;2(7425):1275
4165410
Semin Thorac Cardiovasc Surg. 2001 Oct;13(4 Suppl 1):143-7
11805963
Ann Thorac Surg. 1995 Aug;60(2 Suppl):S216-20
7646162
J Cardiothorac Surg. 2007 Oct 05;2:40
17919325
Circulation. 1978 Dec;58(6):1072-83
709763
J Heart Valve Dis. 1996 Nov;5(6):656-61
8953444
Ann Thorac Surg. 2005 Dec;80(6):2180-5
16305867
Ann Thorac Surg. 1999 Dec;68(6):2147-51
10616992
Circulation. 2006 Jul 4;114(1 Suppl):I535-40
16820633
J Thorac Cardiovasc Surg. 1990 Jan;99(1):113-8
2294343
Ann Thorac Surg. 1993 Jul;56(1):88-90; discussion 90-1
8328881
J Heart Valve Dis. 1995 Jul;4 Suppl 1:S85-8; discussion S88-9
8581219
Ann Thorac Surg. 1995 Dec;60(6):1633-8; discussion 1639
8787456
J Heart Valve Dis. 1997 Mar;6(2):134-7
9130120