Hemodynamic assessment of the new aortic carpentier-edwards bioprosthesis

Abstract

Although glutaraldehyde-preserved porcine aortic Hancock heterografts have lower thromboembolism incidence than mechanical aortic valves, Hancock xenografts provide less functional aortic outflow orifices and thereby greater transvalvular gradients than mechanical prostheses. The newly developed aortic Carpentier-Edwards porcine heterografts comprise a thin-walled Elgiloy flexible metal stent covered with Teflon which provides somewhat wider internal orifices than aortic Hancock valves of the same external annulus diameter. Since aortic Carpentier-Edwards xenografts have not been clincially evaluated previously, the present study assessed cardiac function and heterograft performance (1.7 months postoperation) and clinical status (4.2 months postoperation) of 19 patients with severe aortic stenosis and/or regurgitation prior to surgery. Left ventricular end-diastolic pressures decreased (17 to 9 mm Hg), cardiac index remained normal, and clincial symptomatology diminished markedly. Mean peak transxenograft systolic pressure was only 16 mm Hg (valve area 1.73 cm²), without meaningful regurgitation. Thus aortic Carpentier-Edwards bioprostheses provide generally excellent heterograft function which appears more favorable than previous reports of Hancock xenografts.