(P254) HEMODYNAMIC FUNCTION OF CONTEMPORARY SURGICAL AORTIC VALVES 1 YEAR POSTIMPLANT

Friday, October 25, 2024

3:15 PM – 4:15 PM PT

Location: 116-117

Presenting Author(s)

FD

François Dagenais, MD FRSC (he/him/his)

Cardiac Surgeon
Institut Universitaire de Cardiologie et de Pneumologie de Québec
Québec, Quebec, Canada

First Author(s)

FD

François Dagenais, MD FRSC (he/him/his)

Cardiac Surgeon
Institut Universitaire de Cardiologie et de Pneumologie de Québec
Québec, Quebec, Canada

Co-Author(s)

RK

Robert J.M. Klautz, MD, PhD

Professor and Chair, Department of Cardiothoracic Surgery
Leiden University Medical Center
Leiden, Zuid-Holland, Netherlands
Vivek Rao, MD, PhD

Cardiac Surgeon and Surgical Director, Mechanical Circulatory Support, Peter Munk Cardiac Centre
Toronto General Hospital
CSCS
Toronto, Ontario, Canada
MR

Michael J. Reardon, MD

Professor of Cardiothoracic Surgery, Allison Family Distinguished Chair of Cardiovascular Research
Houston Methodist Hospital
Houston, Texas, United States
MD

Michael Deeb, MD

Professor of Surgery
University of Michigan
Ann Arbor, Michigan, United States
MM

Michael G. Moront, MD

Cardiothoracic Surgeon
ProMedica Toledo Hospital
Toledo, Ohio, United States
SL

Stephen H. Little, MD

Professor of Cardiology, John S. Dunn Chair in Clinical Cardiovascular Research and Education
Houston Methodist Hospital
Houston, Texas, United States
LL

Louis Labrousse, MD

Professor of Cardio-Vascular Surgery
Bordeaux Heart University Hospital
Bordeaux-Pessac, Aquitaine, France
Himanshu J. Patel, MD

Richard L. Prager Research Professor and Section Head, Adult Cardiac Surgery
University of Michigan Hospitals
Ann Arbor, Michigan, United States
SI

Saki Ito, MD

Assistant Professor of Medicine, Echocardiography Core Laboratory
Mayo Clinic
Rochester, Minnesota, United States
SL

Shuzhen Li, PhD

Senior Statistics Manager, Cardiac Surgery
Medtronic
Mounds View, Minnesota, United States
JS

Joseph F. Sabik, III, MD

Chair and Professor, Department of Surgery
Case Western Reserve University School of Medicine
Cleveland, Ohio, United States

Senior Author(s)

JO

Jae K. Oh, MD

Professor of Medicine and Director, Echocardiography Core Laboratory
Mayo Clinic
Rochester, Minnesota, United States

Disclosure(s):

François Dagenais, MD FRSC: No relevant disclosure to display

Background: Data on echocardiographic outcomes of surgical valves are needed to assess hemodynamic functioning of the prosthesis after aortic valve replacement (AVR). Previous publications reporting “normal” hemodynamic valve functioning have been limited by small sample sizes, a lack of contemporary valves, and different study designs (eg, single-center vs multicenter, use vs no use of a core lab, randomized vs single-arm). This study pooled data from 4 large, multicenter clinical trials to evaluate hemodynamic functioning of contemporary surgical aortic valves 1 year after implant.

METHODS AND RESULTS: Data from 2958 patients who underwent surgical AVR for moderate or severe aortic stenosis and/or regurgitation were pooled. Echocardiograms were assessed by a single core laboratory. Twenty patients who received a valve model that had been implanted in < 10 patients were excluded, yielding an analysis cohort of 2938. Ten models of surgical aortic valves were included: 4 stented bovine pericardial, 3 stented porcine, 1 stentless, and 2 sutureless. Baseline mean age in the studies ranged from 70.1±9.0 to 83.3±6.4 years, and the mean STS risk of mortality was 1.9±0.7% to 7.5±3.4%. At 1 year, the population mean aortic gradient ranged from 8.6±3.4 to 16.1±6.2 mmHg, and the mean dimensionless velocity index ranged from 0.39 to 0.56. Figure 1 shows the mean aortic gradient and dimensionless velocity index for the 10 valve models. Rates of no prosthesis-patient mismatch (PPM) ranged from 42.9% to 79.5%; moderate PPM, from 13.6% to 33.3%; and severe PPM, from 2.1% to 23.8%. Figure 2 shows the rate of PPM for each valve model.

Conclusion: This pooled cohort is the largest to date of contemporary surgical aortic valves with echocardiograms analyzed by a single core lab. Overall hemodynamic performance at 1 year ranged from good to excellent. These data can serve as a benchmark for other studies and may be useful to evaluate the performance of bioprosthetic surgical valves over time.