Ahmed Abdel Maksoud
Weston General Hospital, UK
Title: A comparison of the haemodynamic performance of five different prosthetic aortic valves implanted at a single cardiothoracic centre in the UK
Biography
Biography: Ahmed Abdel Maksoud
Abstract
Available postoperative echocardiogram parameters within 2.5 years of operation date were compared between valves (N=350: Trifecta 42, Stjude 163, CE 92, Mosaic 32 and Hancock 21 ). Multivariate analysis which took into account patient age and valve size showed a significant difference between valves in postoperative peak/mean gradient (PG/MG), aortic valve area (AVA) and Indexed effective orifice area (IEOA) (N=350). The most significant difference was Trifecta versus each of Mosaic (P=0.000 (PG), 0.001 (AVA), 0.001 (IEOA)), St Jude epic (P=0.000 (PG), 0.000 (AVA), 0.000 (IEOA)), CE (P=0.026 (PG), 0.001 (AVA), 0.001 (IEOA)) and Hancock (P=0.008 (PG), 0.130 (AVA), 0.158 (IEOA)). Mosaic had a higher PG compared to all the other valves (P=0.000). For the most common valve size used (23 mm, n=121), the valves ranked in the following order of increasing pressure gradients: Trifecta (PG=17±3.39, MG=8±2.26, IEOA=1.03 ±0.1, AVA=1.97±0.19, n=12), Hancock (PG=19±4.57, MG=11 ±3.27, IEOA=0.79±0.1, AVA=1.47±0.16, n=9), CE (PG=24±3.52, MG=12±1.06, IEOA=0.82±0.07, AVA=1.59±0.12, n=31), Epic (PG=31±3.06, MG=16±1.79, IEOA=0.7±0.06, AVA=1.29±0.09, n=59) and Mosaic (PG=40±9.92, MG=20±3.1, IEOA=0.7±0.19, AVA=1.18±0.2, n=10). This comparison of a unique combination of valves shows that the new Trifecta valve has consistently low peak gradients