Haemodynamic performance of aortic pericardial bioprostheses and bileafletprostheses at rest and during exercise: implications for the surgical management of patients with small aortic roots
Jr. Gonzalez-juanatey et al., Haemodynamic performance of aortic pericardial bioprostheses and bileafletprostheses at rest and during exercise: implications for the surgical management of patients with small aortic roots, HEART, 82(2), 1999, pp. 149-155
Citations number
26
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Objective-To determine the haemodynamic behaviour, at rest and during exerc
ise, of aortic valve pericardial bioprostheses and different sizes of bilea
flet prosthesis.
Design-Observational study.
Setting-Tertiary medical centre.
Patients and interventions-74 patients (33 women, 41 men; mean age 64 years
) in whom 40 pericardial bioprostheses and 34 bileaflet prostheses sized 19
, 21, or 23 mm had been implanted to replace aortic valves.
Main outcome measures-Doppler echocardiography at rest and at peak exercise
, between 12 and 47 months after surgery.
Results-All patients achieved a significant increase in heart rate, systoli
c blood pressure, and cardiac output with exercise. Transvalvar pressure fa
ll, valve area, and left ventricular systolic and diastolic function indice
s also underwent significant changes with exercise. Reductions in peak and
mean transvalvar pressure, at rest and at peak exercise, were greater in pa
tients with small valves (p < 0.05).Valve areas and effective area index we
re greater in the patients with larger valves (p < 0.001). There were no si
gnificant differences between patients with mechanical and biological prost
heses with regard to transvalvar pressure fall and valve areas at rest and
at peak exercise.
Conclusions-19 mm and 21 mm aortic prostheses and bioprostheses continue to
create significant obstruction, particularly with exercise.