Values for aortic gradients and velocity for mechanical valves one month after surgery

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bluetux

Member
Joined
Jan 26, 2021
Messages
23
Location
Romania, EU
One month after replacing the aortic valve with a mechanical one Sorin Carbomedics 23 mm, the diameters of the left ventricle decreased by about 4-6 mm, the mean gradient decreased by 3 times, from 61 to 20, vmaxAo = 2.75 from 4.88. Now, a month and a half I still have a slight anemia after the operation, the dyspnea of exertion disappeared, I almost completely recovered. I am very curious what values of gradients and maximum aortic velocity had immediately after the operation those who chose the mechanical valve. Lots of Health !
 
That's good your pressure drop went down, which is to be expected, but I wouldn't focus to much on the actual number. Some valves are better than others and there is a large range from one manufacturer to the next. I would concentrate on staying healthy and enjoying your new-found energy.
 
Early Hemodynamic Profile after Aortic Valve Replacement — A Comparison between Three Mechanical Valves

"Abstract​
Introduction: There are scarce data comparing different​
mechanical valves in the aortic position. The objective of this study​
was to compare the early hemodynamic changes after aortic valve​
replacement between ATS, Bicarbon, and On-X mechanical valves.
Methods: We included 99 patients who underwent aortic valve​
replacement with mechanical valves between 2017 and 2019. Three​
types of mechanical valves were used, On-X valve (n=45), ATS AP360​
(n=32), and Bicarbon (n=22). The mean prosthetic valve gradient was
measured postoperatively and after six months.
Results: Preoperative data were comparable between groups,​
and there were no differences in preoperative echocardiographic​
data. Pre-discharge echocardiography showed no difference​
between groups in the ejection fraction (P=0.748), end-systolic​
(P=0.764) and end-diastolic (P=0.723) diameters, left ventricular mass​
index (P=0.348), aortic prosthetic mean pressure gradient (P=0.454),​
and indexed aortic prosthetic orifice area (P=0.576). There was no​
difference in the postoperative aortic prosthetic mean pressure​
gradient between groups when stratified by valve size. The changes​
in the aortic prosthetic mean pressure gradient of the intraoperative​
period, at pre-discharge, and at six months were comparable between​
the three prostheses (P=0.08). Multivariable regression analysis​
revealed that female gender (beta coefficient -0.242, P=0.027), body
surface area (beta coefficient 0.334, P<0.001), and aortic prosthetic
size (beta coefficient -0.547, P<0.001), but not the prosthesis type,
were independent predictors of postoperative aortic prosthetic mean
pressure gradient.
Conclusion: The three bileaflet mechanical aortic prostheses​
(On-X, Bicarbon, and ATS) provide satisfactory early hemodynamics,​
which are comparable between the three valve types and among​
different valve sizes.​
.... The change in aortic prosthetic pressure gradient over the four-time points was significant across all prosthetics types where the mean gradient decreased significantly after valve replacement and then increased significantly from the intraoperative period to pre-discharge and then at six months (P<0.001) . The small but statistically significant increase in the aortic mean pressure gradient at discharge and at the six-month follow-up TTE compared to intraoperative TEE is likely related to changes in hemodynamics and loading conditions.

https://cdn.publisher.gn1.link/bjcvs.org/pdf/0102-7638-rbccv-2020-0273.pdf
 
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