Sohn Suk Ho, Kim Kyung Hwan, Kang Yoonjin, Kim Ji Seong, Choi Jae Woong, Hwang Ho Young
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
J Thorac Dis. 2023 Jul 31;15(7):3673-3684. doi: 10.21037/jtd-23-318. Epub 2023 Jun 30.
Edwards Intuity is designed for rapid deployment based on the structure of Magna Ease. This study was conducted to compare early hemodynamic performance between the two valves.
Patients who underwent aortic valve replacement (AVR) using Edwards Intuity or Carpentier-Edwards PERIMOUNT Magna Ease in our institution from June 2016 to July 2021 were enrolled. Intuity valve was used in 215 patients, and Magna Ease valve was used in 198 patients, respectively. Early postoperative echocardiographic data were available in 99.0% (409/413) of the patients. The transvalvular mean pressure gradient, effective orifice area, and effective orifice area index were compared between the valves stratified by prosthesis size.
There were no differences in the proportion of female patients or body surface area between the groups. Mean pressure gradient on early postoperative echocardiography was significantly lower in Intuity valve than Magna Ease valve for 19, 21, 23, and 25 mm valves (15.5±5.0 20.8±9.1 mmHg, P=0.004; 12.7±4.2 15.6±5.3 mmHg, P=0.001; 11.5±3.3 13.4±5.8 mmHg, P=0.034; and 9.9±3.1 12.3±4.0 mmHg, P=0.029; respectively). Effective orifice area was larger in Intuity valve than Magna Ease valve for 19 mm valve (1.45±0.38 1.19±0.28 cm, P=0.002), and effective orifice area index was also larger in Intuity valve than Magna Ease valve for 19 mm valve (0.96±0.26 0.80±0.20 cm/m, P=0.005). Early clinical outcomes, including operative mortality and postoperative complications, demonstrated no significant differences between the groups.
Edwards Intuity demonstrated superior early hemodynamic performance compared with Magna Ease in a size-by-size comparison, and this superiority was more definite for small prostheses.
爱德华兹Intuity瓣膜是基于Magna Ease瓣膜的结构设计用于快速部署。本研究旨在比较这两种瓣膜的早期血流动力学性能。
纳入2016年6月至2021年7月在本机构接受使用爱德华兹Intuity瓣膜或卡彭蒂埃 - 爱德华兹PERIMOUNT Magna Ease瓣膜进行主动脉瓣置换术（AVR）的患者。分别有215例患者使用Intuity瓣膜，198例患者使用Magna Ease瓣膜。99.0%（409/413）的患者可获得术后早期超声心动图数据。按人工瓣膜尺寸分层比较瓣膜之间的跨瓣平均压力阶差、有效瓣口面积和有效瓣口面积指数。
两组间女性患者比例或体表面积无差异。术后早期超声心动图显示，对于19、21、23和25毫米瓣膜，Intuity瓣膜的平均压力阶差显著低于Magna Ease瓣膜（分别为15.5±5.0对20.8±9.1 mmHg，P = 0.004；12.7±4.2对15.6±5.3 mmHg，P = 0.001；11.5±3.3对13.4±5.8 mmHg，P = 0.034；9.9±3.1对12.3±4.0 mmHg，P = 0.029）。对于19毫米瓣膜，Intuity瓣膜的有效瓣口面积大于Magna Ease瓣膜（1.45±0.38对1.19±0.28 cm，P = 0.002），并且对于19毫米瓣膜，Intuity瓣膜的有效瓣口面积指数也大于Magna Ease瓣膜（0.96±0.26对0.80±0.20 cm/m²，P = 0.005）。早期临床结局，包括手术死亡率和术后并发症，两组间无显著差异。
在逐尺寸比较中，爱德华兹Intuity瓣膜与Magna Ease瓣膜相比显示出更优的早期血流动力学性能，并且这种优势在小尺寸人工瓣膜中更明显。
