In vitro Hydraulic Performance Data for the Available Prostheses

It is very difficult to compare hydraulic performance of prostheses to the next in vivo. While measurements can be obtained by

Table 64.1. Age Adjusted Aortic Valve Performance.

Freedom from

Freedom From

Valve Aortic

Structural

Thromboembolic

Freedom From

Freedom From

Freedom From

Position

Deterioration

Event

Hemorrhage

Reoperation

Endocarditis

Starr-Edwards361

100%

75%

75%

80%

93%

St. Jude372

100%

90% ± 4%

81% ± 11%

94% ± 3%

NA

Metronic-Hall53

100%

87% ± 4%

80% ± 8%

97% ± 2%

96% ± 2%

Carbomedics124

100%

94% ± 1%

87% ± 1%

95% ± 1%

98% ± 1%

Omniscience135

100%

89% ± 4%

98% ± 1%

95% ± 2%

95% ± 2%

Omnicarbon136

100%

95% ± 3%

100%

97% ± 2%

97% ± 1%

CE Porcine217

39% ± 8%

76% ± 3%

98% ± 1%

37% ± 8%

93% ± 1%

First generation

CE Porcine208

82% ± 6%

85% ± 2%

96% ± 1%

80% ± 6%

96% ± 1%

Second generation

Hancock II233

92% ± 3%

80% ± 4%

96% ± 3%

89% ± 2%

95% ± 1%

Medtronic Intact

97% ± 1%

94% ± 1%

98% ± 1%

94% ± 2%

95% ± 1%

Porcine259

CE Pericardial 2810

100%

95% ± 3%

95% ± 2%

100%

98% ± 1%

1: 20 Years;2:16 years;3:

10 years; 4: 5 years;

5: 9 years; 6: 4 years; 7:

17 years; 8: 12 years;

9: 7 years; 10: 8 years.

Table 64.2. Age Adjusted Mitral Valve Performance.

Freedom from

Freedom From

Valve Mitral

Structural

Thromboembolic

Freedom From

Freedom From

Freedom From

Position

Deterioration

Event

Hemorrhage

Reoperation

Endocarditis

St. Jude372

100%

86% ± 7%

90% ± 7%

93% ± 3%

NA

Metronic-Hall53

100%

91% ± 3%

86% ± 5%

88% ± 4%

88% ± 4%

Carbomedics124

100%

89% ± 2%

87% ± 1%

95% ± 3%

98% ± 1%

CE Porcine167

14% ± 4%

79% ± 3%

83% ± 6%

10% ± 5%

93% ± 1%

CE Porcine218

82% ± 6%

76% ± 10%

96% ± 1%

40% ± 8%

92% ± 2%

Second generation

Hancock II243

81% ± 6%

88% ± 3%

97% ± 3%

81% ± 6%

96% ± 1%

Porcine

Medtronic Intact9

97% ± 2%

94% ± 1%

98% ± 2%

94% ± 2%

95% ± 1%

Porcine26

CE Pericardial3010

79% ± 13%

92% ± 3%

98% ± 2%

66% ± 11%

95% ± 3%

1: 20 Years;2: 16 years;3:

10 years; 4: 5 years;

5: 9 years; 6: 4 years; 7:

17 years; 8: 12 years;

9: 7 years;10: 8 years.

echocardiography, the characteristics of valves do change over time and the best evaluation is done with serial echocardiographic studies over many years. Explant studies also define the fact that the hydraulic and hemodynamic performance of a given prosthesis at the time of implantation changes and evolves over time. However, it is helpful to have in vitro hydraulic performance data for the comparison of various valves as a starting point for selection, and as an estimate of relative performance early after implantation (Table 64.3).

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