HEMODYNAMIC CHARACTERIZATION OF THE CARBOMEDICS MITRAL-VALVE PROSTHESIS

Background and aims of the study: The hemodynamic function of the Carb oMedics bileaflet mitral valve prosthesis was evaluated by Doppler ech ocardiography and by heart catheterization. The clinical state of the invasively examined patients was evaluated before and after surgery. M ethods: Doppler echocardiography was performed in 54 patients at six m onths after surgery. Further, combined right and left heart catheteriz ation was performed in 22 of these patients before surgery and at six months thereafter. Results: The Doppler mean gradients were small (3.6 +/- 1.2 mmHg), and corresponded well with Doppler mean gradients in t he subgroup examined with both methods (3.5 +/- 1.1 mmHg) and with the invasive gradients (3.4 +/- 1.9 mmHg); there was also no difference b etween the different valve sizes. Clinically, pressure recovery distal to the valve is probably so small that no systematic difference betwe en the two techniques of measurement is present. Only physiological re gurgitation was found, and no case of valve dysfunction. The patients improved from functional NYHA class 3.1 +/- 0.4 to 1.4 +/- 0.6, regard less of preoperative diagnosis, with most pronounced improvement in th ose with mitral stenosis. Pulmonary artery pressure was normalized. Pu lmonary vascular resistance and cardiac index improved slightly. Concl usions: In conclusion, the valvular prostheses demonstrated excellent hemodynamic function. There was striking agreement between the small i nvasive and non-invasive gradients. Finally, the functional status of the patients improved considerably, most distinctly in those patients with prior mitral stenosis.