title: Assessment of the St. Jude Medical Regent prosthetic valve by continuous-wave Doppler and dobutamine stress echocardiography.
abstract: BACKGROUND
  The St. Jude Medical (SJM) Regent prosthetic valve (St. Paul, MN), a recently developed mechanical valve, is an improvement on the conventional SJM valve, having a wider valve area than the SJM HP valve. We evaluated this mechanical valve by Doppler echocardiography and dobutamine stress echocardiography (DSE).
  
  
  METHODS
  The functions of the SJM Regent valve were evaluated by continuous-wave Doppler echocardiography and DES in 58 cases of aortic valve replacement during a stable postoperative period.
  
  
  RESULTS
  The peak pressure gradient of the replaced valves sized 17, 19, 21, and 23 mm was 27.5 +/- 11.1, 20.0 +/- 9.8, 15.6 +/- 5.7, and 14.3 +/- 9.1, mm Hg respectively, and the effective orifice area index was 0.97 +/- 0.32, 1.01 +/- 0.29, 1.09 +/- 0.30, and 1.41 +/- 0.54 cm(2)/m(2), respectively, with prosthesis-patient mismatch (PPM) found in 1, 3, 2, and 0 cases for the 17-, 19-, 21- and 23-mm valves, respectively, with a total incidence of 10.3%. In 20 cases, the peak pressure gradient and the effective orifice area index were significantly increased during DSE compared with those at rest.
  
  
  CONCLUSIONS
  Although the PPM incidence was 6.6%, it was deemed from the data of DSE and clinical symptoms that there were no clinical issues for such cases of PPM in the early and intermediate phases after operation. Particularly, the effectiveness of the 17- and 19-mm valves in patients with a small aortic annulus was demonstrated, confirming the satisfactory functions of the SJM Regent prosthetic valve.
authors.affiliation: Department of Cardiovascular Surgery, Sekino Hospital, Nihon University School of Medicine, Tokyo, Japan. asezai@med.nihon-u.ac.jp
authors.forename: Akira
authors.initials: A
authors.lastname: Sezai
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kasamaki
authors.forename: Keisuke
authors.initials: K
authors.lastname: Abe
authors.forename: Mitsumasa
authors.initials: M
authors.lastname: Hata
authors.forename: Hisakuni
authors.initials: H
authors.lastname: Sekino
authors.forename: Kazuma
authors.initials: K
authors.lastname: Shimura
authors.forename: Kazutomo
authors.initials: K
authors.lastname: Minami
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001783:Blood Flow Velocity / Q000502:physiology; D015150:Echocardiography, Doppler / Q000379:methods*; D025401:Echocardiography, Stress / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011474:Prosthesis Design; D012189:Retrospective Studies; D013997:Time Factors; D016277:Ventricular Function, Left / Q000502:physiology*