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The Edwards Prima stentless valve: hemodynamic performance at one year.
U Bortolotti1, G Scioti, A Milano
1Department of Cardiology, Angiology and Pneumology, University of Pisa Medical School, Italy. u.bortolotti@cardchir.med.unipi.it
The Annals of Thoracic Surgery
|January 5, 2000
Summary
The Edwards Prima stentless valve (EPSV) showed improved hemodynamic performance one year after aortic valve replacement, with reduced gradients and left ventricular hypertrophy. Root replacement offered better early results in specific patient groups.
Area of Science:
- Cardiovascular Surgery
- Biomaterials in Medical Devices
- Prosthetic Heart Valves
Background:
- The Edwards Prima stentless valve (EPSV) is a porcine aortic root prosthesis.
- It is fixed in glutaraldehyde under low pressure with resected coronary ostia.
Purpose of the Study:
- To evaluate the hemodynamic performance of the EPSV one year post-aortic valve replacement.
- To assess gradient changes, effective orifice area, regurgitation, and left ventricular hypertrophy regression.
Main Methods:
- 29 patients received EPSV in subcoronary (n=23) or root replacement (n=6) positions.
- Doppler echocardiography assessed hemodynamics at 1 week, 6 months, and 1 year.
- Key metrics included transprosthetic velocity, gradients, effective orifice area, and regurgitation.
Main Results:
- No operative deaths; one late death due to endocarditis.
- Subcoronary EPSV showed high initial gradients that regressed significantly by 1 year (p < 0.03).
- Effective orifice area remained stable; significant left ventricular hypertrophy regression was observed in both groups.
Conclusions:
- Subcoronary EPSV demonstrates improving hemodynamic function post-surgery, with gradient reduction over time.
- Inward Dacron cloth folding at the right coronary ostium contributes to initial gradients.
- Root replacement may yield superior early hemodynamic outcomes in patients with aortic stenosis and specific anatomical features.