title: One-year hemodynamic comparison of Perimount Magna with St Jude Epic aortic bioprostheses.
abstract: BACKGROUND
  Cardiac surgeons are using more bioprosthetic valves due to the ageing population as well as to improvements that have been made to these implants. We sought to compare the 1-year hemodynamics of two commercially available valves by echocardiographic parameters.
  
  
  METHODS
  Retrospective review of our institutional database revealed 69 patients who received either Perimount Magna (n = 33) or St Jude Epic (n = 36) valves in the aortic position with no other valve surgery between June 2004 and March 2006. All patients received transthoracic echocardiography at 1 year. Comparisons between groups were made at baseline and at 1-year follow-up. In addition, a pairwise comparison was performed in each patient to determine the change in echocardiographic parameters between baseline and follow-up.
  
  
  RESULTS
  Mean implanted valve size was similar (Magna 24.3 ±2.0 mm vs. Epic 24.1 ±2.2 mm). Pre- and intraoperative patient variables were similar between the two groups. There were lower peak and mean pressure gradients in the Magna group, both at discharge and one year after surgery. This correlated with a larger indexed effective orifice area (Magna 0.8 ±0.2 cm(2)/m(2) vs. Epic 0.67 ±0.2 cm(2)/m(2), p = 0.02). In spite of these findings, left ventricular mass regression was not different.
  
  
  CONCLUSIONS
  These findings suggest that in a series with relatively low indexed effective orifice areas, the peak and mean gradients obtained were acceptable. More clinical follow-up of these patients is required to assess the true impact of prosthesis patient mismatch.
authors.affiliation: Peter Munk Cardiac Centre, Toronto General Hospital, Toronto, Ontario, Canada.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Bobiarski
authors.forename: Andrew E
authors.initials: AE
authors.lastname: Newcomb
authors.forename: Abdelsalam M
authors.initials: AM
authors.lastname: Elhenawy
authors.forename: Manjula
authors.initials: M
authors.lastname: Maganti
authors.forename: Joanne
authors.initials: J
authors.lastname: Bos
authors.forename: Suzanne
authors.initials: S
authors.lastname: Hemeon
authors.forename: Vivek
authors.initials: V
authors.lastname: Rao
keywords: aortic valve replacement; echocardiography; outcomes