Clinical Evaluation and Comparison of the ATS Medical Open Pivot Prosthetic Valve and St. Jude's Medical Prosthetic Valve in the Aortic Position / 日本心臓血管外科学会雑誌

ABSTRACT

The valvular function after aortic valve replacement was examined using Doppler echocardiography and changes in serum lactate dehydrogenase (LDH) and free hemoglobin levels were assessed. Data for the ATS Medical open pivot prosthetic valve were compared with those of the St. Jude's Medical prosthetic (SJM) valve, a similar bileaflet valve. These have been used in the past 5 years. There were 23 patients with ATS valves (13 men and 10 women, with a mean age of 60.4±13.8 years) and 16 patients with SJM valves (10 men and 6 women, with a mean age of 61.4±8.7 years). The left ventricular diastolic diameter index (LVDdI), left ventricular systolic diameter index (LVDsI), % fractional shortening (%FS) and left ventricular mass index (LVMI) were determined by echocardiography. The peak pressure gradients of the aortic prosthetic valves were calculated by a simplified Bernoulli equation. Postoperative LVDdI, LVDsI and LVMI were not significantly different in the ATS group and the SJM group. However, the %FS of the ATS group was significantly higher than that of the SJM group with aortic stenosis. The pressure gradients at the aortic prosthetic valve position were not significantly different between ATS and SJM valve in the 19-mm, 21-mm and 23-mm size. Postoperative improvement or recovery of the serum LDH level was observed significantly more frequently in the ATS group than the SJM group (<i>p</i><0.005). The free hemoglobin level of the ATS group was also lower than that of the SJM group (<i>p</i><0.005). We demonstrated satisfactory valvular function of the ATS valve compared with the SJM valve. Postoperative improvement of hemolysis was observed significantly more frequently and more rapidly in the ATS valves.