Noera G, Pensa P, Lamarra M, Mascagni R, Cremonesi A, Balestra G
Department of Cardiothoracic Surgery, Casa di Cura Villa Maria Cecilia, Cotignola (RA), Italy.
Eur J Cardiothorac Surg. 1997 Mar;11(3):473-5; discussion 475-6. doi: 10.1016/s1010-7940(96)01090-1.
A Doppler echocardiographic study was performed to evaluate the hemodynamic performance of three 19 mm size currently used bileaflet valve prosthesis (St Jude Medical Hydrodinamic Plus, Sorin-Bicarbon and Carbomedic Reduced) implanted in aortic position.
Patients, 30, with the same profile receiving 19 mm size valve (ten for each valve type) were selected when body surface area (BSA) was > 1.7 m2. Doppler echocardiography was carried out at rest and after exercise, 60 days after surgery. Peak (Pg) and mean (Mg) gradients across the valve were recorded: the effective orifice area (EOA), and performance index (PI) were calculated.
No significant differences were observed between St Jude Medical and Sorin Bicarbon as far as peak and mean gradient, effective orifice area and performance index at rest and after exercise. A significant difference (P < 0.05) was demonstrated in the above mentioned parameters when Carbomedics-R valve were tested. This type of valve showed a lower EOA and PI with higher Pg and Mg gradient both at rest and after exercise.
The St Jude Hydrodymanic plus (Hp) and Sorin Bicarbon valves had similar performance and a better hemodynamic trend when compared to the Carbomedics-R valve in patients with large body surface areas. The Carbomedics-R valve shows a ineffective use of the total area of the prosthesis both at rest and after exercise.
进行了一项多普勒超声心动图研究，以评估三种目前使用的19毫米尺寸双叶瓣人工瓣膜（圣犹达医疗公司的Hydrodinamic Plus、索林-碳酸氢盐和卡波美迪克斯减小型）植入主动脉位置后的血流动力学性能。
选择30例体表面积（BSA）>1.7平方米、接受19毫米尺寸瓣膜（每种瓣膜类型10例）且情况相同的患者。术后60天，在静息和运动后进行多普勒超声心动图检查。记录瓣膜两端的峰值（Pg）和平均（Mg）压差：计算有效瓣口面积（EOA）和性能指数（PI）。
就静息和运动后的峰值和平均压差、有效瓣口面积和性能指数而言，圣犹达医疗公司的瓣膜和索林-碳酸氢盐瓣膜之间未观察到显著差异。对卡波美迪克斯-R瓣膜进行测试时，上述参数显示出显著差异（P<0.05）。这种类型的瓣膜在静息和运动后均显示出较低的EOA和PI，以及较高的Pg和Mg压差。
在体表面积较大的患者中，与卡波美迪克斯-R瓣膜相比，圣犹达Hydrodymanic plus（Hp）瓣膜和索林-碳酸氢盐瓣膜具有相似的性能和更好的血流动力学趋势。卡波美迪克斯-R瓣膜在静息和运动后均显示出对人工瓣膜总面积的利用效率低下。
