Südkamp M, Lercher A J, Müller-Riemenschneider F, LaRosee K, Tossios P, Mehlhorn U, de Vivie E R
Department of Cardiothoracic Surgery, University of Cologne, Germany.
Thorac Cardiovasc Surg. 2003 Jun;51(3):126-9. doi: 10.1055/s-2003-40317.
By changing the design of the St. Jude Medical Regent prosthesis in shifting both sewing cuff and retaining ring into a completely supra-annular position, the Regent valve has a greater geometric orifice for a given outer diameter. Accordingly, in vitro studies have shown increased effective orifice areas (EOAs) and lower transvalvular gradients. The aim of our study was to determine in vivo transvalvular gradients and EOAs in patients after aortic valve replacement (AVR).
We investigated 75 patients at 12 to 21 months follow-up after AVR using transthoracic echocardiography. We determined left ventricular systolic and diastolic function, EOA, and transvalvular peak gradient parameters at rest. Outcomes were assessed using the NYHA classification and functional status.
No patient experienced cardiac failure. The majority reported good functional status and good quality of life. Five (6.7 %) late deaths were observed within the surveillance period. At follow-up, 92 % of the patients had improved by at least one NYHA class. Transvalvular peak gradients at rest for patients with Regent valves were 25.4 +/- 7.7 mmHg, 19.2 +/- 4.6 mmHg, 15.6 +/- 5.8 mmHg, 14.6 +/- 5.5 mmHg, and 8.5 +/- 2.5 mmHg; EOAs were 1.38 +/- 0.32 cm2, 1.62 +/- 0.49 cm2, 2.24 +/- 0.83 cm2, 2.63 +/- 0.70 cm2, and 3.28 +/- 0.34 cm2 for valve sizes 19 mm, 21 mm, 23 mm, 25 mm, and 27 mm, respectively.
The SJM Regent valve shows excellent in vivo hemodynamics as confirmed by echocardiography. Clinically, 92 % of the patients improved by at least one NYHA class.
通过改变圣犹达医疗公司Regent人工瓣膜的设计，将缝合袖口和固定环都移至完全位于瓣环上方的位置，Regent瓣膜在给定外径下具有更大的几何开口面积。因此，体外研究显示有效开口面积（EOA）增加且跨瓣压差降低。我们研究的目的是确定主动脉瓣置换术（AVR）后患者的体内跨瓣压差和EOA。
我们使用经胸超声心动图对75例接受AVR术后12至21个月随访的患者进行了研究。我们测定了静息状态下的左心室收缩和舒张功能、EOA以及跨瓣峰值压差参数。使用纽约心脏协会（NYHA）分级和功能状态评估结果。
无患者发生心力衰竭。大多数患者报告功能状态良好且生活质量良好。在监测期内观察到5例（6.7%）晚期死亡。随访时，92%的患者NYHA分级至少改善了一级。Regent瓣膜患者静息时的跨瓣峰值压差分别为25.4±7.7 mmHg、19.2±4.6 mmHg、15.6±5.8 mmHg、14.6±5.5 mmHg和8.5±2.5 mmHg；瓣膜尺寸为19 mm、21 mm、23 mm、25 mm和27 mm时的EOA分别为1.38±0.32 cm²、1.62±0.49 cm²、2.24±0.83 cm²、2.63±0.70 cm²和3.28±0.34 cm²。
经超声心动图证实，圣犹达医疗公司Regent瓣膜在体内显示出优异的血流动力学表现。临床上，92%的患者NYHA分级至少改善了一级。
