The Hemodynamic Performance of Carpentier-Edwards PERIMOUNT Magna for Aortic Valve Stenosis

(Department of Cardiovascular Surgery, Shizuoka City Hospital, Shizuoka, Japan)

Daisuke Takahashi Mitsuomi Shimamoto Fumio Yamazaki
Masanao Nakai Yujiro Miura Tatsuya Itonaga
Tatsuji Okada Ryota Nomura Noriyuki Abe
Yasuhiko Terai
This study compared the hemodynamic performance of the Carpentier-Edwards PERIMOUNT Magna bioprosthesis(Magna)with the Carpentier-Edwards PERIMOUNT bioprosthesis(CEP)for aortic valve stenosis(AS). Between January 2005 and May 2010, 164 patients underwent aortic valve replacement for AS with either the Magna(n=68)or the CEP(n=96)at our institute. Patients undergoing a concomitant mitral valve procedure were excluded from this study. The 21-mm Magna and CEP prostheses were the most frequently used during this period. Transthoracic echocardiography was postoperatively performed within 2 weeks. The peak velocity(PV)of the Magna was significantly lower than that of the CEP(2.59±0.36 vs. 2.75±0.47m/s;p=0.022). The mean pressure gradient(PG)was not significantly different. For the 19-mm prostheses, the mean PG and PV of the Magna were significantly lower than those of the CEP[16.4±4.5 vs. 19.7±6.4mmHg;p=0.034(PG)and 2.70±0.36 vs. 3.03±0.49m/s;p=0.008(PV)]. The effective orifice area(EOA)of the Magna was larger than that of the CEP[19mm:1.29±0.18 vs. 1.11±0.24cm2p=0.007);21mm:1.46±0.23 vs. 1.42±0.18cm2p=0.370);and 23mm:1.70±0.34 vs. 1.52±0.25cm2p=0.134)]. In this study, the EOA of the Magna was approximately 80% of that described in the manufacture’s description. Patient-prosthesis mismatch(PPM;EOA index≤0.85cm2/m2)was seen in 26.8% of patients with the Magna and in 47.2% of patients with the CEP(p=0.018). Severe PPM(EOA index≤0.65cm2/m2)was not seen in any patients with the Magna. The EOA of the 19-mm Magna was significantly larger and the mean PG was lower than those of the 19-mm CEP. Compared with the CEP, the Magna significantly reduced the incidence of PPM, and had superior hemodynamic performance.
  Jpn. J. Cardiovasc. Surg. 40:81-85(2011)

Keywords:aortic valve replacement, bioprosthesis, patient-prosthesis mismatch, effective orifice area, aortic valve stenosis