Do differences in early hemodynamic performance of current generation biologic aortic valves predict outcomes 1 year following surgery? Nassir M. Thalji,

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Presentation transcript:

Do differences in early hemodynamic performance of current generation biologic aortic valves predict outcomes 1 year following surgery? Nassir M. Thalji, MBChB, Rakesh M. Suri, MD, DPhil, Hector I. Michelena, MD, Kevin L. Greason, MD, Joseph A. Dearani, MD, Richard C. Daly, MD, Lyle D. Joyce, MD, John M. Stulak, MD, Harold M. Burkhart, MD, Zhuo Li, MSc, Hartzell V. Schaff, MD The Journal of Thoracic and Cardiovascular Surgery Volume 149, Issue 1, Pages 163-173.e2 (January 2015) DOI: 10.1016/j.jtcvs.2014.09.027 Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Flow diagram of patient flow from enrollment to 1-year follow-up. Epic (St Jude, St Paul, Minn), Magna (Edwards LifeSciences Inc, Irvine, Calif), and Mitroflow (Sorin Biomedica Spa, Saluggio, Italy). Op, Operative. The Journal of Thoracic and Cardiovascular Surgery 2015 149, 163-173.e2DOI: (10.1016/j.jtcvs.2014.09.027) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 One-year aortic valve prosthesis hemodynamic parameters stratified by labeled valve size: Nos. 19 and 21, No. 23, and Nos. 25, and 27. A, Mean gradient was significantly lower in the Magna group for large size (Nos. 25 and 27) devices. B, Aortic valve area was significantly higher in the Magna group for large size (Nos. 25 and 27) devices. C, Indexed aortic valve area was significantly higher in the Magna group for large size (Nos. 25 and 27) devices. Means and medians are represented by diamonds and lines inside the box respectively. Top and bottom box borders encompass the middle 50% of the data. Start indicates statistically significant comparison. Epic (St Jude, St Paul, Minn), Magna (Edwards LifeSciences Inc, Irvine, Calif), and Mitroflow (Sorin Biomedica Spa, Saluggio, Italy). The Journal of Thoracic and Cardiovascular Surgery 2015 149, 163-173.e2DOI: (10.1016/j.jtcvs.2014.09.027) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 One-year aortic valve prosthesis hemodynamic parameters stratified by actual annular size (universal sizer) measured directly at surgery: <23 mm, 23 mm, and >23 mm. A, Mean gradient was significantly lower in the Magna group for patients with a mid-size (23 mm) and large (>23 mm) annulus. B, Aortic valve area was significantly higher in the Magna group in patients with a midsize (23 mm) annulus. C, Indexed aortic valve area were significantly higher in the Magna group in patients with a midsize (23 mm) annulus. Means and medians are represented by diamonds and lines inside the box, respectively. Top and bottom box borders encompass the middle 50% of the data. Start indicates statistically significant comparison. Epic (St Jude, St Paul, Minn), Magna (Edwards LifeSciences Inc, Irvine, Calif), and Mitroflow (Sorin Biomedica Spa, Saluggio, Italy). The Journal of Thoracic and Cardiovascular Surgery 2015 149, 163-173.e2DOI: (10.1016/j.jtcvs.2014.09.027) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Left ventricular (LV) mass index regression in Epic (St Jude, St Paul, Minn), Magna (Edwards LifeSciences Inc, Irvine, Calif), and Mitroflow (Sorin Biomedica Spa, Saluggio, Italy) groups. Regression in indexed LV mass from preoperative to 1-year postoperative assessment was significant within Epic, Magna, and Mitroflow groups (P < .001), but comparable among groups (P = .262). The graph shows means and standard error of the mean (means ± SD at each time point are shown below the graph). The Journal of Thoracic and Cardiovascular Surgery 2015 149, 163-173.e2DOI: (10.1016/j.jtcvs.2014.09.027) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions