The Hemodynamic Performance of Carpentier-Edwards PERIMOUNT Magna for Aortic Valve Stenosis / 日本心臓血管外科学会雑誌

ABSTRACT

This study compared the hemodynamic performance of the Carpentier-Edwards PERIMOUNT Magna bioprosthesis (Magna) with the Carpentier-Edwards PERIMOUNT bioprosthesis (CEP) for aortic valve stenosis (AS). Between January 2005 and May 2010, 164 patients underwent aortic valve replacement for AS with either the Magna (<i>n</i>=68) or the CEP (<i>n</i>=96) at our institute. Patients undergoing a concomitant mitral valve procedure were excluded from this study. The 21-mm Magna and CEP prostheses were the most frequently used during this period. Transthoracic echocardiography was postoperatively performed within 2 weeks. The peak velocity (PV) of the Magna was significantly lower than that of the CEP (2.59±0.36 vs. 2.75±0.47 m/s ; <i>p</i>=0.022). The mean pressure gradient (PG) was not significantly different. For the 19-mm prostheses, the mean PG and PV of the Magna were significantly lower than those of the CEP [16.4±4.5 vs. 19.7±6.4 mmHg ; <i>p</i>=0.034 (PG) and 2.70±0.36 vs. 3.03±0.49 m/s ; <i>p</i>=0.008 (PV)]. The effective orifice area (EOA) of the Magna was larger than that of the CEP [19 mm 1.29±0.18 vs. 1.11±0.24 cm² (<i>p</i>=0.007) ; 21 mm 1.46±0.23 vs. 1.42±0.18 cm² (<i>p</i>=0.370) ; and 23 mm 1.70±0.34 vs. 1.52±0.25 cm² (<i>p</i>=0.134)]. In this study, the EOA of the Magna was approximately 80% of that described in the manufacture's description. Patient-prosthesis mismatch (PPM ; EOA index≤0.85 cm²/m²) was seen in 26.8% of patients with the Magna and in 47.2% of patients with the CEP (<i>p</i>=0.018). Severe PPM (EOA index≤0.65 cm²/m²) was not seen in any patients with the Magna. The EOA of the 19-mm Magna was significantly larger and the mean PG was lower than those of the 19-mm CEP. Compared with the CEP, the Magna significantly reduced the incidence of PPM, and had superior hemodynamic performance.