POSTOPERATIVE DOPPLER-ECHOCARDIOGRAPHIC EVALUATION IN DIFFERENT SIZESOF MEDTRONIC-HALL, BIOCOR AND CARPENTIER-EDWARDS SAV PROSTHETIC AORTIC VALVES

Doppler echocardiography was performed on 108 patients 4-15 days after implantation of a Medtronic-Hall, Biocor or Carpentier-Edwards S.A.V. prosthetic aortic valve because of aortic stenosis. Significant corre lation was found between the in vitro (maker-declared) and the Doppler -estimated effective prosthetic valve orifice area (r = 0.70, p < 0.01 ). Doppler-estimated prosthetic valve orifice area, but not transprost hetic blood velocities, discriminated between different sizes of Medtr onic-Hall and Biocor valves. The effective orifice area in these valve s was 57% of the in vitro area, but in Carpentier-Edwards valves it wa s only 43%. Transprosthetic blood velocity was inversely related to or ifice area in men, but not in women, who also had longer duration of s ystole and better preservation of systolic left ventricular function. The data suggest that the effective prosthetic valve areas found in pa tients are significantly smaller than the experimental in vitro areas. Prosthesis size and type, anatomic and hemodynamic variables and gend er are important in Doppler estimation of effective valve area.