Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
J Artif Organs. 2021 Dec;24(4):458-464. doi: 10.1007/s10047-021-01262-8. Epub 2021 Mar 26.
To assess the early hemodynamics after mitral valve replacement (MVR) using the St Jude Medical (SJM) Epic bioprosthesis. MVR was performed using the SJM Epic bioprosthesis in 35 patients from June 2018 to April 2020; three patients were excluded because the postoperative transthoracic echocardiography (TTE) data were unavailable. Data from postoperative TTE at 1 week and 3 months after the procedure were reviewed. The mean mitral pressure gradient (mMPG) was calculated using a continuous wave Doppler method. Left ventricular outflow tract (LVOT) was calculated using a pulse wave Doppler method. The effective orifice area (EOA) was measured from pressure half time. There were 12 men (37.5%) and 20 women (62.5%) with a mean age of 75.9 years (61-88 years). The mean body surface area was 1.51 ± 0.22 cm. The 25 mm and 27 mm valves were used in more than 50% of cases. The mMPG was 4.9 ± 1.7 mmHg and 5.4 ± 1.6 mmHg at 1 week and 3 months after surgery, respectively. EOA was 2.18 ± 0.50 cm and 2.31 ± 0.59 cm at 1 week and 3 months after surgery, respectively. The peak velocity of the LVOT (n = 22) was 103.3 ± 21.3 cm/s and 106.8 ± 27.4 cm/s at 1 week and 3 months after surgery, respectively. No findings suggested paravalvular regurgitation and LVOT obstruction. Using the SJM Epic bioprosthesis in MVR resulted in satisfactory hemodynamics in the early postoperative period, even with small valve sizes. Further accumulation of cases and evidence, including mid- to long-term results, is required in the future.
评估使用圣犹达医疗（SJM）Epic 生物瓣行二尖瓣置换术（MVR）后的早期血流动力学。2018 年 6 月至 2020 年 4 月，我们对 35 例患者使用 SJM Epic 生物瓣进行了 MVR，其中 3 例患者因术后经胸超声心动图（TTE）数据不可用而被排除。回顾了术后 1 周和 3 个月的 TTE 数据。使用连续波多普勒法计算平均二尖瓣压力梯度（mMPG）。使用脉冲波多普勒法计算左心室流出道（LVOT）。从压力减半时间测量有效瓣口面积（EOA）。有 12 名男性（37.5%）和 20 名女性（62.5%），平均年龄为 75.9 岁（61-88 岁）。平均体表面积为 1.51±0.22cm。25mm 和 27mm 瓣膜的使用超过了 50%。术后 1 周和 3 个月的 mMPG 分别为 4.9±1.7mmHg 和 5.4±1.6mmHg。术后 1 周和 3 个月的 EOA 分别为 2.18±0.50cm 和 2.31±0.59cm。22 例 LVOT 峰值速度分别为 103.3±21.3cm/s 和 106.8±27.4cm/s。无瓣周漏和 LVOT 梗阻的发现。在 MVR 中使用 SJM Epic 生物瓣可在术后早期获得满意的血流动力学，即使使用小瓣口尺寸。未来还需要进一步积累病例和证据，包括中期至长期结果。
