REFERENCE DOPPLER-ECHOCARDIOGRAPHIC VALUES FOR ST-JUDE-MEDICAL, OMNICARBON, AND BIOCOR PROSTHETIC VALVES IN THE AORTIC POSITION

The objectives of the present investigation were (1) to describe Doppl er echocardiographic findings for mechanical and biologic aortic valve s at an early stage after operation and later in a stable phase and (2 ) to study the changes occurring between these investigations. Patient s (n = 213) who received a mechanical (St. Jude Medical, Omnicarbon) o r a biologic (Biocor) valve were studied by Doppler echocardiography w ithin the first week (baseline, n = 203) and after 2 years (late, n = 172). The comparison of baseline with late investigation (mean +/- SD) showed an increase in systolic blood pressure (137 +/- 18.5 to 154 +/ - 20.6 mm Hg, p = 0.0001, n = 112), reduction of heart rate (85 +/- 15 .3 to 74 +/- 12.0 beats/ min, p = 0.0001, n = 141) and increase in str oke volume (59 +/- 20.6 to 77 +/- 19.8 ml, p = 0.0001, n = 132). Prost hetic Doppler echocardiographic findings demonstrated a reduction in b lood flow velocity in the left ventricular outflow tract (V-LVOT, 1.10 +/- 0.25 to 0.96 +/- 0.23 m/sec, p = 0.0001, n = 146) reduction in pe ak velocity (V-max, 2.72 +/- 0.53 to 2.59 +/- 0.54 m/sec, p = 0.02, n = 150), reduction in mean pressure gradient (Delta P-mean, 18.4 +/- 7. 2 to 16.3 +/- 7.3 mm Hg, p = 0.004) and an increase in velocity index (V-max/V-LVOT, 2.56 +/- 0.62 to 2.67 +/- 0.60, p = 0.003, n = 144). Th e standard deviations of difference between baseline and late investig ation expressed as percentage of mean were 25% for V-LVOT, 20% for V-m ax, 44% for Delta P-mean, and 25% for velocity index. In conclusion, t his large reference base provides data that should be useful for the c linician evaluating patients with prosthetic valves early after valve replacement as well as at a later stage. When valve dysfunction is sus pected a previous investigation for comparison is helpful, and our dat a describe the changes that normally may be seen between an early base line and a late investigation.