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Meeting abstract

https://doi.org/10.15836/ccar2023.119

The inner diameter of the prosthetic aortic valve, an additional factor in achieving better hemodynamic parameters after surgical aortic valve replacement

Tomo Svaguša orcid id orcid.org/0000-0002-2036-1239 ; Dubrava University Hospital, Zagreb, Croatia
Dubravka Šušnjar orcid id orcid.org/0000-0002-9644-9739 ; Dubrava University Hospital, Zagreb, Croatia
Stjepan Cvetković ; University Hospital Centre Osijek, Osijek, Croatia
Matija Drinković orcid id orcid.org/0009-0002-5442-3247 ; University Hospital Centre Osijek, Osijek, Croatia
Grgur Dulić orcid id orcid.org/0000-0002-7300-0840 ; University Hospital Centre Osijek, Osijek, Croatia


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Abstract

Keywords

aortic stenosis; prosthetic aortic valve; inner diameter

Hrčak ID:

301075

URI

https://hrcak.srce.hr/301075

Publication date:

27.4.2023.

Visits: 409 *



In patients with an implanted aortic valve, the importance of obtaining the maximum values of velocity and flow over the valve is extremely important to obtain adequate data on hemodynamics. However, the variability between the obtained values of ultrasound measurements in the same patients and among different ultrasound specialists has been known for a long time. Also, differences in hemodynamics between different manufacturers of heart valves are known, with a note that the larger the valve, the more favorable the hemodynamic effect on the valve is. By measuring the average internal diameter (ID) of the biological aortic valve in comparison with the body surface area (BSA) and the body mass index (BMI), an adequate instrument can be obtained for the comparison of different cardiac surgical centers. ID could also be a parameter that would allow us to compare different manufacturers of prosthetic aortic valves. (1,2) The aim is to show the results of one center over a year, the average ID of the aortic valve and its relationship with body surface area and body mass index.

The study included patients from University Hospital Centre Osijek, who were treated for severe isolated aortic valve stenosis from January to December 2022, and who have had a biological aortic valve implanted. Patients who had dilatation of the ascending part of the aorta, who had an implanted mechanical aortic valve, and who had significant aortic regurgitation in addition to aortic stenosis were excluded from data analysis. For adequate assessment and comparison with other centers, the average UP is expressed in relation to body surface area and body mass index. Patient’s data and measured values are shown inTable 1. Data are shown as average ± standard deviation. The presence of a bicuspid aortic valve, the left ventricular ejection fraction, and the presence of postoperative aortic regurgitation were not examined in the presentation of the results. The above should be examined in more detail in future research.

TABLE 1 Patient data.
N54
MALE35
AGE (year)68.07 ± 7.10
HEIGHT (cm)167.68 ± 9.59
MASS (kg)81.58 ± 15.41
BSA (m2)1.94 ± 0.21
BMI (kg/m2)29 ± 4.77
INTERNAL DIAMETER (mm)21.4 ± 1.87
INTERNAL DIAMETER/BSA (mm/m2)11.13 ± 0.89
INTERNAL DIAMETER/BMI (mm/kg/m2)0.76 ± 0.12

BSA = body surface area, BMI = body mass index

Due to the different sizes of biological aortic valves used in clinical practice, we believe that the average internal diameter of the valve (the part through which blood passes) indexed by body surface area or body mass index would be adequate data for comparing different types of aortic valves. Also, it could become one of the parameters for comparison with different cardiac surgery centers.

LITERATURE

1 

Pibarot P, Magne J, Leipsic J, Côté N, Blanke P, Thourani VH, et al. Imaging for Predicting and Assessing Prosthesis-Patient Mismatch After Aortic Valve Replacement. JACC Cardiovasc Imaging. 2019 January;12(1):149–62. https://doi.org/10.1016/j.jcmg.2018.10.020 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/30621987

2 

Joury A, Duran A, Stewart M, Gilliland YE, Spindel SM, Qamruddin S. Prosthesis-patient mismatch following aortic and mitral valves replacement - A comprehensive review. Prog Cardiovasc Dis. 2022 May-June;72:84–92. https://doi.org/10.1016/j.pcad.2022.02.004 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/35235847


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