Background. The hemodynamic performance of aortic replacement prostheses is
of extreme importance. There is renewed interest in hemodynamics because o
f the influence of prosthesis-patient mismatch on left ventricular mass reg
ression and the potential influence on survival.
Methods. The hemodynamic performance of the second-generation Carpentier-Ed
wards supraannular porcine and pericardial (Perimount) bioprostheses and th
e third-generation Medtronic Mosaic porcine bioprosthesis were compared for
mean gradient and effective orifice area index. The effective orifice area
index of at least 0.85 cm(2)/M-2 was considered as lack of prosthesis-pati
ent mismatch. The study group included included 53 patients with Carpentier
-Edwards supraannular porcine, 48 with pericardial, and 98 with Medtronic M
osaic porcine bioprostheses.
Results. The mean gradients were not different between the prostheses by pr
osthesis size. The Medtronic Mosaic was not provided in size 19. The mean g
radients for the prostheses, except in the very large sizes, were all doubl
e-digit values. The effective orifice area index was not different between
the prostheses but there was a trend toward prosthesis-patient mismatch in
smaller size prostheses.
Conclusions. There was no apparent hemodynamic advantage between porcine an
d pericardial bioprostheses in the aortic position. (C) 2001 by The Society
of Thoracic Surgeons.