DOPPLER-ECHOCARDIOGRAPHIC ASSESSMENT OF THE CARBOMEDICS SUPRAANNULAR TOP-HAT PROSTHETIC HEART-VALVE IN THE AORTIC POSITION

Twenty-one CarboMedics 'Top-Hat' bileaflet prostheses were implanted i n the aortic position between May 1993 and May 1994 at our institution . Valve performance was assessed by repeat echocardiography. We found it very easy to implant this prosthesis even in the small aortic annul us and it allowed us to implant a valve that is at least one size larg er than implantation in the intra-annular position allows. The only co ntraindication to the implantation of this prosthesis is when the coro nary ostia are displaced downwards, which would apply to any supra-ann ular prosthesis. The Doppler echocardiographic assessment showed accep table transvalvular gradients and velocity indexes. The Top-Hat prosth esis is now our valve of choice in the small aortic annulus.