+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Early Hemodynamic Results in Patients With Small Aortic Annulus After Aortic Valve Replacement

Early Hemodynamic Results in Patients With Small Aortic Annulus After Aortic Valve Replacement

Innovations 12(4): 254-258

Patients with a small aortic annulus (≤21 mm) have an increased risk of patient-prosthesis mismatch after valve replacement. The aim of this study was to compare the early hemodynamic performance of the balloon-expandable transaortic valve implantation Edwards system (SAPIEN) and the sutureless Perceval prostheses. Fifty patients underwent transcatheter aortic valve implantation, and 113 patients underwent sutureless aortic valve replacement. Mean ± SD aortic annulus diameter was 19.7 ± 1 mm, with no significant difference between groups. SAPIEN valve size was 23 mm in 40 patients (80%) and 26 mm in 10 patients (20%). Perceval valve size was small in 45 patients (40%), medium in 62 patients (55%), and large in 6 patients (5%). Transthoracic Doppler echocardiographic images were collected at baseline and before discharge. There were no significant difference in predischarge effective orifice area (SAPIEN: 1.5 ± 0.5 cm and Perceval: 1.48 ± 0.34 cm, P = 0.58) and indexed effective orifice areas (SAPIEN: 0.93 ± 0.32 cm/m and Perceval: 0.88 ± 0.22 cm/m, P = 0.42). Predischarge mean ± SD transaortic gradient was lower with the SAPIEN than with Perceval valves (12 ± 6 and 17 ± 6 mm Hg, respectively, P < 0.001). Rates of moderate and severe prosthesis-patient mismatch were similar (SAPIEN: 44% and 10% and Perceval: 50% and 14%, P = 0.53 and 0.75, respectively). There were no moderate-severe paravalvular leaks. Although indexed effective orifice areas were similar, transcatheter aortic valve implantation with the balloon-expandable SAPIEN system yielded lower predischarge transaortic mean gradients than the surgically implanted Perceval, in patients with a small annulus.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 059638537

Download citation: RISBibTeXText

PMID: 28598875

DOI: 10.1097/imi.0000000000000380

Related references

Early Hemodynamic Results In Patients With Small Aortic Annulus Undergoing Surgical Sutureless Aortic Valve Replacement (Perceval) And Balloon-Expandable Transcatheter Aortic Valve Implantation. Canadian Journal of Cardiology 32(10): S305-S306, 2016

Results of aortic valve replacement in patients with a narrow aortic annulus effects of enlargement of the aortic annulus. Annals of Thoracic Surgery 31(2): 111-116, 1981

Aortic Valve Replacement in Elderly Patients With Small Aortic Annulus: Results With Three Different Bioprostheses. Innovations 14(1): 27-36, 2019

Long-term results after aortic root replacement using self-assembled valve composite grafts in patients with small aortic annulus. Interactive Cardiovascular and Thoracic Surgery 18(2): 159-163, 2014

Early in vivo hemodynamic results after aortic valve replacement with the St Jude Medical Regent mechanical heart valve in patients with pure aortic stenosis. Journal of Cardiac Surgery 18(2): 125-132, 2003

Surgical aortic valve replacement for valve-in-valve trans-catheter aortic valve dysfunction in the patient with a small aortic annulus. New Zealand Medical Journal 131(1483): 66-69, 2018

Long-term results for aortic valve replacement with small aortic annulus. Artificial Organs 26(5): 474-478, 2002

Long-term results of conventional aortic valve replacement for small aortic annulus. Kyobu Geka. Japanese Journal of Thoracic Surgery 59(4): 306-312, 2006

Hemodynamics after aortic valve replacement with St. Jude Medical valve for patients with small aortic annulus and severe left ventricular hypertrophy. Journal of Heart Valve Disease 7(1): 86-93, 1998

Surgical technique of aortic valve replacement for small aortic annulus in elderly patients. Kyobu Geka. Japanese Journal of Thoracic Surgery 59(4): 283-287, 2006

Aortic valve replacement with anterior and posterior enlargement of small aortic annulus is comparable to surgery with normal annulus. Revista Portuguesa de Cardiologia 25(6): 593-602, 2006

An appraisal of patch enlargement of the small aortic annulus in 33 patients undergoing aortic valve replacement. European Journal of Cardio-Thoracic Surgery 6(7): 347-349, 1992

Evaluation of aortic valve replacement involving small severely calcified aortic annulus in elderly patients. Kyobu Geka. Japanese Journal of Thoracic Surgery 59(4): 336-339, 2006

Aortic valve replacement for aortic stenosis with a small aortic annulus in a patient having Werner's syndrome and liver cirrhosis. Annals of Thoracic and Cardiovascular Surgery 7(6): 378-380, 2001

Long-term Mortality Predictors in Patients with Small Aortic Annulus Undergoing Aortic Valve Replacement with a 19- or 21-mm Bioprosthesis. Brazilian Journal of Cardiovascular Surgery 31(4): 275-280, 2016