Rubino, AS, Biancari, F, Caruso, V, et al. Hemodynamic assessment of Perceval sutureless bioprosthesis by dobutamine stress echocardiography. Echocardiography. 2018; 35: 64– 70. https://doi.org/10.1111/echo.13735
Hemodynamic assessment of Perceval sutureless bioprosthesis by dobutamine stress echocardiography
|Author:||Rubino, Antonino S.1,2; Biancari, Fausto3,4,5; Caruso, Vincenzo1;|
1Cardiac Surgery Unit, A.O.U. “Policlinico-Vittorio Emanuele,” Ferrarotto Hospital, University of Catania, Catania, Italy
2Heart Center, Fondazione “G.B Morgagni,” Pedara, Catania, Italy
3Heart Center, Turku University Hospital, Turku, Finland
4Department of Surgery, University of Turku, Turku, Finland
5Department of Surgery, University of Oulu, Oulu, Finland
6Cardiology Unit, A.O.U. “Policlinico-Vittorio Emanuele,”Ferrarotto Hospital, University of Catania, Catania, Italy
7Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
|Online Access:||PDF Full Text (PDF, 0.3 MB)|
|Persistent link:|| http://urn.fi/urn:nbn:fi-fe2019101532786
John Wiley & Sons,
|Publish Date:|| 2019-10-15
Objectives: The aim of this study was to evaluate the hemodynamic performance of a sutureless bioprosthesis under high workload at mid‐term follow‐up.
Methods: Thirty‐two patients who underwent isolated aortic valve replacement with a Perceval sutureless bioprosthesis with a minimum follow‐up of 1 year were enrolled in this study. S size prosthesis was deployed in 10 patients (31.3%), M size in 9 (28.1%), L size in 8 (25%) and XL size in 5 (15.6%). Effective orifice area (EOA), EOA index (EOAi), and transvalvular gradients were assessed at rest and during dobutamine stress echocardiography (DSE) a median of 19.5 months after surgery.
Results: Dobutamine stress echocardiography (DSE) significantly increased heart rate, stroke volume, ejection fraction, and transvalvular gradients (peak gradient, 24.0 ± 7.6 vs 38.7 ± 13.6 mm Hg, P < .001; mean gradient, 12.6 ± 4.2 vs 19.8 ± 8.3, P < .001). When compared to baseline, estimated valve areas significantly increased at follow‐up (EOA, 1.48 ± 0.46 vs 2.06 ± 0.67, P < .001; EOAi, 0.84 ± 0.26 vs 1.17 ± 0.37, P < .001). Mean percentage increase in EOAi was 40.3% ± 28.0%. S size prostheses had the highest increase in EOA1, but the difference was not significant (S 46.0% ± 27.5% vs M 45.4% ± 34.5% vs L 32.7% ± 26.4% vs XL 32.1% ± 20.5%, P = .66). Severe patient‐prosthesis mismatch (EOAi ≤ 0.65 cm²/m²) was present at rest in 8 patients (25%), but only in one patient (3.1%) during DSE.
Conclusions: The Perceval sutureless bioprosthesis demonstrated good hemodynamics at rest and under high workload. The significant increase in EOAi during DSE suggests the potential advantages of Perceval sutureless bioprostheses in case of small aortic annulus or when patient‐prosthesis mismatch is anticipated.
|Pages:||64 - 70|
|Type of Publication:||
A1 Journal article – refereed
|Field of Science:||
3126 Surgery, anesthesiology, intensive care, radiology
ASR received a research grant from LivaNova PLC, London, United Kingdom. CM is consultant for LivaNova PLC, London, United Kingdom.
© 2017 Wiley Periodicals, Inc. This is the peer reviewed version of the following article: Rubino, AS, Biancari, F, Caruso, V, et al. Hemodynamic assessment of Perceval sutureless bioprosthesis by dobutamine stress echocardiography. Echocardiography. 2018; 35: 64– 70. https://doi.org/10.1111/echo.13735, which has been published in final form at https://doi.org/10.1111/echo.13735. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.