Long-Term Doppler Hemodynamics and Effective Orifice Areas of Edwards SAPIEN and Medtronic CoreValve Prostheses after TAVI

Autor: Henryk Dreger, Verena Stangl, Karl Stangl, Sebastian Spethmann, Herko Grubitzsch, Gert Baumann, Michael Sander, Gerd Baldenhofer, Eyleen Pflug, Wasiem Sanad, Michael Laule, Fabian Knebel
Rok vydání: 2013
Předmět:
Male
Aortic valve
Cardiac Catheterization
medicine.medical_specialty
Time Factors
Hemodynamics
Regurgitation (circulation)
Doppler echocardiography
Prosthesis Design
Risk Assessment
Severity of Illness Index
Statistics
Nonparametric
Cohort Studies
symbols.namesake
Internal medicine
Confidence Intervals
medicine
Humans
Radiology
Nuclear Medicine and imaging
Prospective Studies
Prospective cohort study
Aged
Aged
80 and over
Bioprosthesis
Heart Valve Prosthesis Implantation
Observer Variation
Mitral regurgitation
medicine.diagnostic_test
business.industry
Stroke Volume
Aortic Valve Stenosis
Middle Aged
Echocardiography
Doppler
Prosthesis Failure
Treatment Outcome
medicine.anatomical_structure
Cardiology
symbols
Female
Cardiology and Cardiovascular Medicine
business
Doppler effect
Body orifice
Follow-Up Studies
Zdroj: Echocardiography. 31:302-310
ISSN: 0742-2822
Popis: Background Although initial hemodynamics of percutaneously implanted aortic bioprostheses compare favorably to surgically implanted valves, the durability of the flow characteristics remains unknown. As biological prostheses are at potential risk for early degeneration, the aim of our study was to compare Doppler hemodynamics and effective orifice area (EOA) directly after and at least 1 year after valve implantation. Methods In this monocentric, prospective study, we determined peak velocity, peak and mean systolic gradients, and EOA by echocardiography in 75 patients (Edwards SAPIEN, n = 20; CoreValve, n = 55) 1 week (median 7 ± 25 days) and 1 year (median 378 ± 157 days, maximum 1034 days) after transcatheter aortic valve implantation (TAVI). Results After 12 months, Doppler performance of the aortic valve prostheses remained unchanged. The peak instantaneous velocity was 1.9 ± 0.4 m/s directly after TAVI versus 1.8 ± 0.5 m/s (P = ns) at follow-up, with a mean gradient of 8.5 ± 3.7 mmHg and 8.1 ± 4.2 (P = ns), respectively. Interestingly, the degree of mitral regurgitation (MR) decreased significantly (P = 0.007) over time, and the severity of aortic regurgitation (AR) remained unchanged during follow-up (P = ns). Conclusion For at least 1 year after TAVI, the excellent Doppler hemodynamics and EOA are preserved in transcatheter aortic valve prostheses, and the severity of MR decreased significantly. In addition, we found no evidence of early valve deterioration or progression of AR.
Databáze: OpenAIRE
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