Exercise Echocardiography in Cryopreserved Aortic Homografts: Comparison of a Prototype Stentless, a Stented Bioprosthesis, and Native Aortic Valves

Background: Aortic valve replacement with a cryopreserved aortic homograft (CH) is an attractive alternative to bioprosthesis implantation. The aim of the study was to compare the hemodynamic performance of CH implanted with aortic root inclusion compared to prototype stentless (SS) bioprosthesis, s...

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Bibliographic Details
Published in:Echocardiography (Mount Kisco, N.Y.) N.Y.), 2009-11, Vol.26 (10), p.1204-1210
Main Authors: Cordovil, Adriana, Filho, Orlando Campos, De Andrade, José Lázaro, Rodrigues, Ana Clara Tude, Gerola, Luis Antonio, Moises, Valdir, Buffolo, Enio, De Camargo Carvalho, Antonio Carlos
Format: Article
Language:English
Subjects:
Adult
Aged
aortic
Aortic Valve - transplantation
Bioprosthesis
Blood Vessel Prosthesis
Cryopreservation - methods
Doppler echocardiography
exercise
Exercise Test
Female
Heart Valve Diseases - diagnostic imaging
Heart Valve Diseases - surgery
Heart Valve Prosthesis
homografts
Humans
Male
Middle Aged
Stents
Treatment Outcome
Ultrasonography
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Summary:Background: Aortic valve replacement with a cryopreserved aortic homograft (CH) is an attractive alternative to bioprosthesis implantation. The aim of the study was to compare the hemodynamic performance of CH implanted with aortic root inclusion compared to prototype stentless (SS) bioprosthesis, standard stented (SD) bioprosthesis, and a native aortic valve. Methods: Hemodynamics and Doppler echocardiographic measurements such as left ventricular ejection fraction, aortic valve orifice area index (AVOAI), mean and maximal transvalvular gradients, were obtained at rest and immediately after exercise in 28 patients after aortic valve replacement with CH (n = 10), SS (n = 9), or SD (n = 9), and in a control group (CG) of 15 normal volunteers. Results: Rest and peak exercise heart rate and workload achieved were not different among the groups. Baseline AVOAI was larger for CH and CG compared to SS and SD groups (P < 0.05). Maximal and mean transvalvular pressure gradients at rest were lower for CH compared to SS and SD groups (P < 0.05), but higher than CG (P < 0,05). Conclusion: Implanted aortic CH had better hemodynamic performance than SS and SD bioprosthesis and similar to native normal aortic valves, both at rest and immediately after exercise. (ECHOCARDIOGRAPHY, Volume 26, November 2009)
ISSN:0742-2822
1540-8175
DOI:10.1111/j.1540-8175.2009.00940.x