DOPPLER-ECHOCARDIOGRAPHIC COMPARISON OF SMALL (19MM) BILEAFLET AND PERICARDIAL HEART-VALVE PROSTHESES IN AORTIC POSITION

The resting haemodynamics of five types of small (19 mm) aortic valve prosthesis (2 bileaflet, 3 pericardial) were evaluated with Doppler ec hocardiography in 43 patients. Two received St Jude Medical and six Ca rboMedics bileaflet valves and 35 were given bioprostheses-16 Ionescu- Shiley, four Mitroflow and 15 Labcor-Santiago. No significant differen ces in peak or mean transvalvular pressure drop or in effective valve area were found between the bileaflet and the pericardial valves or am ong the three types of bioprosthesis. All but one of the bileaflet pro stheses showed a characteristic regurgitation pattern, with two latera l and one central jet, and 16 (46%) of the bioprostheses showed centra l regurgitation, but in no case were these jets haemodynamically signi ficant. Thus the 19 mm bileaflet and the studied pericardial prosthese s all have satisfactory resting haemodynamics, and all are suitable fo r implanting in small aortic roots.