HEMODYNAMIC EVALUATION OF THE CARBOMEDICS-R, ST-JUDE-MEDICAL HP AND SORIN-BICARBON VALVE IN PATIENTS WITH SMALL AORTIC ANNULUS

A Doppler echocardiographic study was performed to evaluate the hemody namic performance of three 19 mm size currently used bileaflet valve p rosthesis (St Jude Medical Hydrodinamic Plus, Sorin-Bicarbon and Carbo medic Reduced) implanted in aortic position. Methods: Patients, 30, wi th the same profile receiving 19 mm size valve (ten for each valve typ e) were selected when body surface area (BSA) was > 1.7 m(2). Doppler echocardiography was carried out at rest and after exercise, 60 days a fter surgery. Peak (Pg) and mean (Mg) gradients across the valve were recorded: the effective orifice area (EGA), and performance index (PI) were calculated. Results: No significant differences were observed be tween St Jude Medical and Sorin Bicarbon as far as peak and mean gradi ent, effective orifice area and performance index at rest and after ex ercise. A significant difference (P<0.05) was demonstrated in the abov e mentioned parameters when Carbomedics-R valve were tested. This type of valve showed a lower EOA and PI with higher Pg and Mg gradient bot h at rest and after exercise. Conclusion: The St Jude Hydrodymanic plu s (Hp) and Sorin Bicarbon valves had similar performance and a better hemodynamic trend when compared to the Carbomedics-R valve in patients with large body surface areas. The Carbomedics-R valve shows a ineffe ctive use of the total area of the prosthesis both at rest and after e xercise. (C) 1997 Elsevier Science B.V.