Postoperative Hemodynamic Performance after Aortic Valve Replacement Using the Carpentier-Edwards Pericardial Valves

(Department of Cardiovascular Surgery, Nobeoka Prefectural Hospital, Nobeoka, Japan)

Kouji Furukawa Masachika Kuwabara Eisaku Nakamura
Masakazu Matsuyama
Postoperative hemodynamic performance after aortic valvular replacement using the Carpentier-Edwards pericardial valve of 19-mm (group A, 10 cases) or 21-mm (group B, 5 cases) was compared with that using the 19-mm St. Jude Medical hemodynamic plus (group C, 13 cases). We evaluated hemodynamic performance by measuring the peak pressure gradient via aortic valve using Doppler echocardiography. Preoperative peak pressure gradients were 80}18.5mmHg in A, 81.6}17.5mmHg in B and 87}36.3mmHg in C. Valvular replacement obviously improved the hemodynamic performance by decreasing the postoperative peak pressure gradient to 24.2}7.3mmHg in A, 14.2}6.2mmHg in B and 26.7}19.0mmHg in C, though no statistically significant difference was present among the three groups. We also applied the dobutamine stress test for 5 cases in group A, 4 in B and 4 in C, who could receive the additional examination. The amount of dobutamine given was 8.2}1.6ƒĘg/kg/min in A, 7.2}2.0ƒĘg/kg/min in B and 7.7}1.5ƒĘg/kg/min in C. Before administration of dobutamine, the peak pressure gradient was 18.1}4.3mmHg in A, 14.2}6.2mmHg in B and 20.9}5.7mmHg in C. Although administration of dobutamine increased the peak pressure gradient to 41.1}15.0mmHg in A, 32.2}9.8mmHg in B and 46.8}14.4mmHg in C, there was no significant difference among the groups. The Carpentier-Edwards pericardial valve of 19-mm and 21-mm thus provided satisfactory valvular function compared with the 19-mm St. Jude Medical in terms of hemodynamics. Therefore, it is concluded that the Carpentier-Edwards pericardial valve is a reliable alternative for elderly patients.
@Jpn. J. Cardiovasc. Surg. 32F240 -242 (2003)