A prospective, randomized comparison of 3 contemporary bioprosthetic aortic valves: Should hemodynamic performance influence device selection? Rakesh.

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Presentation transcript:

A prospective, randomized comparison of 3 contemporary bioprosthetic aortic valves: Should hemodynamic performance influence device selection? Rakesh M. Suri, MD, DPhil, Hector I. Michelena, MD, Harold M. Burkhart, MD, Kevin L. Greason, MD, Richard C. Daly, MD, Joseph A. Dearani, MD, Soon J. Park, MD, Lyle D. Joyce, MD, John M. Stulak, MD, Thoralf M. Sundt, MD, Zhuo Li, MS, Hartzell V. Schaff, MD The Journal of Thoracic and Cardiovascular Surgery Volume 144, Issue 6, Pages 1387-1398 (December 2012) DOI: 10.1016/j.jtcvs.2012.07.105 Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Early aortic valve prosthesis hemodynamics 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 mid- (no. 23) to large-size (nos. 25 and 27) devices. B, Mean aortic valve area (± 95% confidence internal whiskers) was significantly higher in the Magna group for mid- (no. 23) to large-size (nos. 25 and 27) devices. C, Mean indexed aortic valve area was significantly higher in the Magna group for only mid-size (no. 23) devices. Mean and median are represented by the squares and lines inside the box. Top and bottom box borders cover the middle 50% of the data. Star indicates statistically significant comparison. The Journal of Thoracic and Cardiovascular Surgery 2012 144, 1387-1398DOI: (10.1016/j.jtcvs.2012.07.105) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Early aortic valve prosthesis hemodynamics stratified by actual annular size (universal sizer) measured directly at surgery: <23 mm, 23 mm, and >23 mm. A, Mean gradient was only lower in the Magna group in patients with a large aortic annulus (>23 mm). B, Mean aortic valve area was similar among all valves when stratified by each actual annulus size. C, Mean indexed aortic valve area was only higher in the Magna group for patients with a midsize (23-mm) aortic annulus. Mean and median are represented by the squares and lines inside the box. Top and bottom box borders cover the middle 50% of the data. Star indicates statistically significant comparison. The Journal of Thoracic and Cardiovascular Surgery 2012 144, 1387-1398DOI: (10.1016/j.jtcvs.2012.07.105) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Incidence of severe patient–prosthesis mismatch (PPM; calculated as indexed aortic valve area <0.6cm2/m2). The frequency of severe PPM was statistically similar among groups when stratified by either labeled valve size (A) or actual annular size (universal sizer; B). The Journal of Thoracic and Cardiovascular Surgery 2012 144, 1387-1398DOI: (10.1016/j.jtcvs.2012.07.105) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions