Toshihiko Kinoshita

Hemodynamic performance of the Edwards Prima Plus stentless valve at 1 year

PurposeThe Edwards Prima Plus stentless valve bioprosthesis (EPPSV) is a porcine aortic root cylinder with resected coronary ostia, fixed in glutaraldehyde at low pressure, and chemically treated to prevent calcification. Utilization of this valve was approved in January 2005 in Japan. The purpose of this study was to evaluate the early hemodynamic performance of EPPSVs in our experience.Materials and methodsFrom April 2005 to January 2006, a total of 21 patients underwent aortic valve replacement with EPPSVs. The hemodynamic performance of EPPSVs was evaluated at the time of discharge (2 weeks) and at 1 year by transthoracic two-dimensional Doppler echocardiography.ResultsThere was one non-valve-related early death and one non-valve-related late death. Hemodynamic data were available for comparison from the time of discharge and at 1 year postoperatively in 19 patients (mean valve size 22 ± 1 mm). Hemodynamic follow-up showed a significant decrease in the peak and mean transvalvular pressure gradients at discharge (37 ± 16 and 18 ± 8 mmHg, respectively) and 1 year postoperatively (25 ± 7 and 12 ± 4 mmHg, respectively) (P < 0.01). The effective orifice area increased significantly between the time of discharge (1.31 ± 0.31 cm2) and 1 year (1.57 ± 0.37 cm2) (P < 0.05) postoperatively. The left ventricular mass index was significantly reduced from the time of discharge (167 ± 49 g/m2) to 1 year postoperatively (126 ± 47 g/m2) (P < 0.001).ConclusionEPPSVs have been associated with high early transprosthetic gradients. Such gradients tend to regress, with significant improvement at 1 year and concomitant regression of left ventricular hypertrophy.