Postoperative Echocardiographic Hemodynamic Comparison between Recently Available Bileaflet Mechanical Valves / 대한흉부외과학회지

ABSTRACT

BACKGROUND: There was no difference between the bileaflet mechanical valves on the midterm and longterm clinical outcome. We reviewed the hemodynamic comparison between recently available mechanical valves by Doppler Echocardiography. MATERIAL AND METHOD: We retrospectively reviewed 396 postoperative hemodynamic datas (EOA, MDPG, and MSPG) by doppler echocardiography in 345 patients. Mechanical valves from 5 venders (Sorin Bicarbon, SJM, ATS, On-X, and Edward MIRA) were compared. There were 232 valves in mitral position, 162 in aortic, and 2 in tricuspid. RESULT: There were 178 men (mean age; 50.6+/-13.9 years old) and 167 women (52.6+/-14.6). MDPG/EOA of 27 mm in mitral position was Sorin; 4.2+/-1.5 mmHg/3.0+/-0.9 cm2, SJM; 2.3+/-1.2/3.5+/-0.6. In 29 mm, Sorin, SJM, ATS, On-X, MIRA revealed 3.4+/-1.2/3.1+/-0.6, 3.3+/-1.1/2.7+/-0.4, 3.8+/-0.8/3.2+/-0.6, 4.0+/-3.0/3.1+/-0.9, 2.9+/-0.9/3.0+/-0.8. In 31 mm, Sorin, SJM, ATS, MIRA revealed 3.9+/-1.9/2.9+/-0.6, 3.5+/-1.2/3.0+/-0.6, 3.4+/-0.8/2.8+/-0.2, 3.7+/-1.5/2.7+/-0.7. In 33 mm, Sorin, SJM, MIRA revealed 4.4+/-0.9/2.5+/-0.4, 3.4+/-1.5/3.3+/-0.5, 4.7+/-2.4/3.0+/-0.3. MSPG/EOA of 19 mm aortic position was Sorin, SJM, ATS, On-X, MIRA 18.0 mmHg/1.2 cm2, 25.6+/-8.7/1.1+/-0.3, 25.9+/-12.6/1.2+/-0.3, 23.0/1.3, 27.9+/-7.1/1.2+/-0.1 in that order. In 21 mm, SJM, ATS, On-X, MIRA revealed 18.3+/-6.7/1.5+/-0.5, 13.7+/-2.1/1.7+/-0.3, 17.0/1.4, 17.1+/-5.5/1.8+/-0.5. In 23 mm Sorin, SJM, ATS, On-X, MIRA revealed 14.0+/-4.6/1.7+/-0.6, 12.8+/-3.2/2.0+/-0.2, 16.8+/-12.2/2.1+/-0.9, 14.0/1.5, 15.0+/-5.5/1.8+/-0.5. In 25 mm, SJM and MIRA revealed 14.0+/-5.1/1.8+/-1.0, 11.0/2.3. There was no statistically significant difference in these values between the venders given the same position and size. 2 redo valve replacements were performed, 1 due to severe hemolysis in ATS and 1 due to leaflet immobilization in SJM. CONCLUSION: Postoperative hemodynamic comparison by doppler echocardiography shows no statistically significant difference between recently available mechanical valves in this country.