Comparison of the Carpentier-Edwards Perimount and St. Jude Medical Epic bioprostheses for aortic valve replacement--a retrospective echocardiographic short-term study.
OBJECTIVE
Stented biological prostheses show different performance related to their design and ultrastructure. Therefore, we compared the Carpentier-Edwards Perimount (Edwards Lifesciences, Irvine, CA, USA) and the St. Jude Medical Epic (SJM Epic; St. Jude Medical Inc., St. Paul, MN, USA) prostheses with respect to their hemodynamic features.


METHODS
Eighty-six patients underwent aortic valve replacement for severe aortic stenosis (50 patients), aortic regurgitation (seven patients), or mixed lesion (29 patients) with these randomly assigned bioprostheses (Perimount: 39 patients; SJM Epic: 47 patients). Following informed consent, patients were examined postoperatively (mean 9.7 +/- 4 months after surgery) with a detailed echocardiographic study, quality of life was determined by a standardized questionnaire.


RESULTS
Comparing the indexed effective orifice area (0.77 cm(2)/m(2) vs. 0.64 cm(2)/m(2); p = 0.019), the mean pressure gradient (11.15 mmHg vs. 14.80 mmHg; p = 0.004) and the stroke-work loss (6.95% vs. 8.49%; p = 0.025), the Carpentier-Edwards Perimount demonstrated significantly better hemodynamic features than the SJM Epic prosthesis. These effects were more pronounced in the smaller prosthetic sizes.


CONCLUSIONS
The Carpentier-Edwards Perimount prosthesis was less obstructive than the SJM Epic in echocardiographic controls. Patient-prosthesis mismatch as determined by indexed effective orifice area showed no impact on functional recovery.
Department of Cardiothoracic Surgery, University of Aachen, Aachen, Germany. agoetzenich@ukaachen.de
Andreas
A
Goetzenich
Georg
G
Langebartels
Stefan
S
Christiansen
Nima
N
Hatam
Rüdiger
R
Autschbach
Guido
G
Dohmen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001705:Bioprosthesis; D018618:Echocardiography, Doppler, Color / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012189:Retrospective Studies; D013318:Stroke Volume; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome