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[The Bjoerk-Shiley and the Lillehei-Kaster valve in aortal position. A hemodynamic comparison]
Insights
The Björk-Shiley (B-S) valve shows better hemodynamics than the Lillehei-Kaster (L-K) valve in aortic positions. L-K valve replacement leads to higher left ventricular pressure loads post-surgery.
Area of Science:
- Cardiovascular Surgery
- Biomedical Engineering
- Cardiac Valve Prostheses
Background:
- Aortic valve replacement is a common procedure.
- Tilting disc valves are frequently used prostheses.
- Hemodynamic performance of different valve types requires comparative analysis.
Purpose of the Study:
- To compare the hemodynamic performance of Björk-Shiley (B-S) and Lillehei-Kaster (L-K) tilting disc valves in the aortic position.
- To evaluate the impact of these prostheses on postoperative left ventricular pressure.
Main Methods:
- Left heart catheterization and cineangiography were performed on 32 patients with aortic tilting disc valves.
- Patients were divided into two groups: 24 with B-S valves and 8 with L-K valves.
- Hemodynamic parameters including left ventricular peak systolic pressure and transprosthetic pressure gradient were measured.
Main Results:
- The L-K group exhibited significantly higher left ventricular peak systolic pressure (174 +/- 22 mm Hg) compared to the B-S group (140 +/- 22 mm Hg) (p < 0.001).
- Mean systolic pressure gradient was significantly higher across L-K valves (34 mm Hg) versus B-S valves (12 mm Hg) (p < 0.001).
- Calculated valve area was significantly smaller for L-K valves (0.9 cm2) than for B-S valves (1.5 cm2).
Conclusions:
- The Björk-Shiley valve demonstrates superior hemodynamic performance compared to the Lillehei-Kaster valve in the aortic position, given similar external dimensions.
- Aortic valve replacement with the Lillehei-Kaster valve is associated with a significant postoperative left ventricular pressure load.
Abstract:
Thirty-two patients with tilting disc valves in the aortic position were evaluated by left heart catheterization and cineangiography. 24 patients had Björk-Shiley valves (B-S group) and 8 Lillehei-Kaster valves (L-K group). At the postoperative hemodynamic evaluation, left ventricular peak systolic pressure was significantly (p less than 0.001) higher in the L-K group (174 +/- 22 mm Hg) than in the B-S group (140 +/- 22 mm Hg). The mean systolic pressure gradient across the prosthesis was significantly (p less than 0.001) higher in the L-K group (34 mm Hg) than in the B-S group (12 mm Hg). The calculated valve area at a similar average tissue annulus diameter was significantly smaller in the L-K group (0.9 cm2) than in the B-S group (1.5 cm2). It is concluded (1) that in the aortic position at similar external prosthesis dimensions the B-S valve exhibits superior hemodynamic performance of the L-K valve and (2) that aortic valve replacement by L-K valve is associated with significant postoperative left ventricular pressure load.