Hemodynamic performance evaluation of small aortic ATS Medical valves by Doppler echocardiography

The ATS Medical valve was first implanted in 1992. The purpose of this report was to establish the normal range of each hemodynamic parameter, measured by Doppler echocardiography, in small aortic ATS Medical valves.

Twenty-five patients with small aortic ATS Medical valves, operated on over six months, and with no cardiac or prosthetic dysfunction, in sinus rhythm, on adequate oral anticoagulant therapy, and no other valve prosthesis or significant valvulopathy, were reviewed on the basis of physical examination and transthoracic Doppler echocardiography.

For the aortic 21 Standard ATS Medical valve (n = 10), the following values were registered: peak velocity 2.40 +/- 0.39 m/s; peak gradient 23.7 +/- 6.8 mmHg; mean gradient 12.6 +/- 4.0 mmHg; valve effective orifice area 1.73 +/- 0.41 cm2; Doppler velocity index 0.47 +/- 0.11. For the aortic 19 Standard ATS Medical valve (n = 9), these values were: 3.41 +/- 0.43 m/s; 47.0 +/- 12.6 mmHg; 26.2 +/- 7.9 mmHg; 0.96 +/- 0.18 cm2; and 0.32 +/- 0.06, respectively. For the aortic 16 AP ATS Medical valve (n = 6), these parameters were 3.44 +/- 0.47 m/s; 47.7 +/- 12.0 mmHg; 27.0 +/- 7.3 mmHg; 0.61 +/- 0.09 cm2; and 0.30 +/- 0.04, respectively.

Using Doppler echocardiography, the present study establishes the normal range of parameters which define the hemodynamic performance of the aortic 21 and 19 Standard and 16 AP ATS Medical valves, and demonstrates satisfactory hemodynamic performance of the aortic 21 and 19 Standard ATS Medical valves. It should be noted that the valve effective orifice area determined for the aortic 16 AP ATS Medical valve was smaller than that for the aortic 19 Standard ATS Medical valve, though these two prostheses have the same physical orifice area.