ABSTRACT

Stented tissue heart valve prostheses “BioLab KA-PT” for aortic valve replacement in patients over 60 years of age
S.I. Zheleznev, M.V. Isayan, D.A. Astapov
Novosibirsk Federal Research Institute of Circulation Pathology
Novosibirsk, Russia


Purpose of the study: we assessed immediate results of “BioLab KA-PT” stented xenopericardial valves use for aortic valve replacement (AVR).
Material and methods: Since January 2009 till May 2010 165 patients received “BioLab KA-PT” as aortic valve substitute. Mean age was 69.3±4.5 years (60–82), there were 74 (44,8%) men. Average NYHA functional class was III (II, III). Sizes of the prostheses used were the following: “20” in 53 patients (32%), “22” in 76 (46%), “24”in 34 (20%), and “26”- in 2 (1.2%). Average aortic crossclamp time for isolated AVR was 69.3±14.1 min.
Results: There were 3 (1.8%) hospital deaths и 2 (1,2%) cases of early prosthetic valve dysfunction. In 1 case in was valve thrombosis at 25 day after surgery, and 1 case of the early (26 day) prosthetic regurgitation; for both of them we successfully performed redo surgery. In 1 case we found Type II aortic dissection at 30th day after valve surgery, for which supracoronary replacement of ascending aorta was performed. Prosthetic infective endocarditis rate was 4.8% (8 patients). At the postoperative echocardiography on discharge we found LV EDV index reduction from 62.3±26 до 53.8±17 ml/m2 (р=0.005), LV mass index reduction from 383.5±99.7 to 181.8±47.1 g/m2 (р=0.003), respectively. There were no significant changes in LV ejection fraction (62±11 and 61±9%, respectively, р=0.4). and new hypocinetic or akinetic LV areas. Peak AV prosthesis gradient (PAVPG) was. 19.9±6.4 (7- 40) mm Hg for the entire group. PAVPG analysis in different valve sizes revealed moderate correlation (р < 0.05). Average PAVPG in size “20” was 22.8±5.953, in size “22” – 19.1±5.3, in size“24” – 17.4±7.8, and in size “26” – 13.8±1.6 mm Hg. In all the cases there were complete systolic opening of the prosthetic leaflets, and satisfactory closure in diastole. Average effective area of the valve orifice were 2.6±0.2 cm2: for the size “20” – 2.4±0.2, size “22” – 2.6±0.2 ; size 24 – 2.8±0.1, size 26 – 2.9±0.1 cm2.
Conclusions: Stented bioprosthesis “BioLab KA-PT” is shown good clinical and hemodynamic results in early terms after AVR. Nevertheless, long-term follow up studies are needed, comparing “BioLab KA-PT” to other models of tissue valves.