| Postoperative Hemodynamic Performance
after Aortic Valve Replacement Using the Carpentier-Edwards Pericardial
Valves |
(Department of Cardiovascular Surgery, Nobeoka Prefectural
Hospital, Nobeoka, Japan)
| Kouji Furukawa |
Masachika Kuwabara |
Eisaku Nakamura |
| Masakazu Matsuyama |
|
|
|
Postoperative hemodynamic performance
after aortic valvular replacement using the Carpentier-Edwards
pericardial valve of 19-mm (group A, 10 cases) or 21-mm (group
B, 5 cases) was compared with that using the 19-mm St. Jude Medical
hemodynamic plus (group C, 13 cases). We evaluated hemodynamic
performance by measuring the peak pressure gradient via aortic
valve using Doppler echocardiography. Preoperative peak pressure
gradients were 80}18.5mmHg in A, 81.6}17.5mmHg in B and 87}36.3mmHg
in C. Valvular replacement obviously improved the hemodynamic
performance by decreasing the postoperative peak pressure gradient
to 24.2}7.3mmHg in A, 14.2}6.2mmHg in B and 26.7}19.0mmHg in
C, though no statistically significant difference was present
among the three groups. We also applied the dobutamine stress
test for 5 cases in group A, 4 in B and 4 in C, who could receive
the additional examination. The amount of dobutamine given was
8.2}1.6Ęg/kg/min in A, 7.2}2.0Ęg/kg/min in B and 7.7}1.5Ęg/kg/min
in C. Before administration of dobutamine, the peak pressure
gradient was 18.1}4.3mmHg in A, 14.2}6.2mmHg in B and 20.9}5.7mmHg
in C. Although administration of dobutamine increased the peak
pressure gradient to 41.1}15.0mmHg in A, 32.2}9.8mmHg in B and
46.8}14.4mmHg in C, there was no significant difference among
the groups. The Carpentier-Edwards pericardial valve of 19-mm
and 21-mm thus provided satisfactory valvular function compared
with the 19-mm St. Jude Medical in terms of hemodynamics. Therefore,
it is concluded that the Carpentier-Edwards pericardial valve
is a reliable alternative for elderly patients.
@Jpn. J. Cardiovasc. Surg. 32F240 -242 (2003) |
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