The Hemodynamic Performance of Carpentier-Edwards PERIMOUNT Magna for Aortic Valve Stenosis
（Department of Cardiovascular Surgery, Shizuoka City Hospital, Shizuoka, Japan）
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±0.24cm2（p＝0.007）；21mm:1.46±0.23 vs. 1.42±0.18cm2（p＝0.370）;and 23mm:1.70±0.34 vs. 1.52±0.25cm2（p＝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