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Short-term hemodynamic performance of the mitral Carpentier-Edwards PERIMOUNT pericardial valve. Carpentier-Edwards
M S Firstenberg1, A J Morehead, J D Thomas
1Department of Cardiology, The Cleveland Clinic Foundation, Ohio 44195, USA.
Insights
The Carpentier-Edwards PERIMOUNT pericardial valve shows good short-term hemodynamic performance in the mitral position. Trace mitral regurgitation was observed but deemed physiologically insignificant.
Area of Science:
- Cardiovascular Surgery
- Biomaterials Science
- Medical Imaging
Background:
- Limited data exist on the hemodynamic performance of the Carpentier-Edwards PERIMOUNT pericardial valve in the mitral position.
- Existing data primarily focus on long-term durability, not immediate hemodynamic function.
Purpose of the Study:
- To evaluate the short-term hemodynamic performance of the Carpentier-Edwards PERIMOUNT pericardial valve in the mitral position.
- To assess valve gradients, effective orifice area, and the incidence of mitral regurgitation.
Main Methods:
- A multicenter study involving 69 patients who received mitral PERIMOUNT valves.
- Short-term echocardiography follow-up at a mean of 600 days post-implantation.
- Blinded core laboratory analysis of echocardiographic data.
Main Results:
- Mean peak gradient was 4.36+/-1.79 mm Hg, inversely related to valve size (p < 0.05).
- Effective orifice area averaged 2.5+/-0.6 cm², tending to increase with valve size (p = 0.08).
- Trace mitral regurgitation (MR) was common (n=48), with 9 patients experiencing mild MR and 1 moderate MR; no severe MR or paravalvular leaks were noted.
Conclusions:
- The PERIMOUNT mitral valves demonstrated physiologically insignificant central mitral regurgitation.
- Hemodynamic performance was comparable to other prosthetic valves, despite echocardiographic limitations.
- The study provides valuable short-term hemodynamic data for this specific prosthetic valve in the mitral position.
Background:
Although long-term durability data exist, little data are available concerning the hemodynamic performance of the Carpentier-Edwards PERIMOUNT pericardial valve in the mitral position.
Methods:
Sixty-nine patients who were implanted with mitral PERIMOUNT valves at seven international centers between January 1996 and February 1997 consented to participate in a short-term echocardiography follow-up. Echocardiographs were collected at a mean of 600+/-133 days after implantation (range, 110 to 889 days); all underwent blinded core lab analysis.
Results:
At follow-up, peak gradients were 9.09+/-3.43 mm Hg (mean, 4.36+/-1.79 mm Hg) and varied inversely with valve size (p < 0.05). The effective orifice areas were 2.5+/-0.6 cm2 and tended to increase with valve size (p = 0.08). Trace mitral regurgitation (MR) was common (n = 48), 9 patients had mild MR, 1 had moderate MR, none had severe MR. All MR was central (n = 55) or indeterminate (n = 3). No paravalvular leaks were observed. Mitral regurgitation flow areas were 3.4+/-2.8 cm2 and were without significant volumes.
Conclusions:
In this multicenter study, these mitral valves are associated with trace, although physiologically insignificant, central MR. Despite known echocardiographic limitations, the PERIMOUNT mitral valves exhibit similar hemodynamics to other prosthetic valves.