Biological

Biological prosthetic valves

Normal values for Biological Aortic Valve Prosthesis

Valve	Type	Size (mm)	Peak gradient (mmHg)	Mean gradient (mmHg)	EOA (cm2)
Baxter Perimount	Stented bovine pericardial	19	32.5 ± 8.5	19.5 ± 5.5	1.3 ± 0.2
		21	24.9 ± 7.7	13.8 ± 4.0	1.3 ± 0.3
		23	19.9 ± 7.4	11.5 ± 3.9	1.6 ± 0.3
		25	16.5 ± 7.8	10.7 ± 3.8	1.6 ± 0.4
		27	12.8 ± 5.4	4.8 ± 2.2	2.0 ± 0.4
Biocor	Stented porcine	23	30.0 ± 10.7	20 ± 6.6	1.3 ± 0.3
		25	23.0 ± 7.9	16 ± 5.1	1.7 ± 0.4
		27	22.0 ± 6.5	15.0 ± 3.7	2.2 ± 0.4
BioFlo	Stented bovine pericardial	19	37.2 ± 8.8	26.4 ± 5.5	0.7 ± 0.1
		21	28.7 ± 6.2	18.7 ± 5.5	1.1 ± 0.1
Carpentier Edwards Pericardial	Stented bovine pericardial	19	32.1 ± 3.4	24.2 ± 8.6	1.2 ± 0.3
		21	25.7 ± 9.9	20.3 ± 9.1	1.5 ± 0.4
		23	21.7 ± 8.6	13.0 ± 5.3	1.8 ± 0.3
		25	16.5 ± 5.4	9.0 ± 2.3
Carpentier Edwards Standard	Stented porcine	19	43.5 ± 12.7	25.6 ± 8.0	0.9 ± 0.2
		21	27.7 ± 7.6	17.3 ± 6.2	1.5 ± 0.3
		23	28.9 ± 7.5	16.1 ± 6.2	1.7 ± 0.5
		25	24.0 ± 7.1	12.9 ± 4.6	1.9 ± 0.5
		27	22.1 ± 8.2	12.1 ± 5.5	2.3 ± 0.6
		29		9.9 ± 2.9	2.8 ± 0.5
Carpentier Supra - Annular	Stented porcine	19	34.1 ± 2.7		1.1 ± 0.1
		21	28.0 ± 10.5	17.5 ± 3.8	1.4 ± 0.9
		23	25.3 ± 10.5	13.4 ± 4.5	1.6 ± 0.6
		25	24.4 ± 7.6	13.2 ± 4.8	1.8 ± 0.4
		27	16.7 ± 4.7	8.8 ± 2.8	1.9 ± 0.7
CryoLife	Stentless	19		9.0 ± 2.0	1.5 ± 0.3
		21		6.6 ± 2.9	1.7 ± 0.4
		23		6.0 ± 2.3	2.3 ± 0.2
		25		6.1 ± 2.6	2.6 ± 0.2
		27		4.0 ± 2.4	2.8 ± 0.3
Extended Biocor	Stentless	19	17.5 ± 6.5	9.6 ± 3.6	1.4 ± 0.4
		21	17.5 ± 6.5	9.6 ± 3.6	1.4 ± 0.4
		23	14.7 ± 7.3	7.7 ± 3.8	1.7 ± 0.4
		25	14.0 ± 4.3	7.4 ± 2.5	1.8 ± 0.4
Hancock	Stented porcine	21	18.0 ± 6.0	12.0 ± 2.0
		23	16.0 ± 2.0	11.0 ± 2.0
		25	15.0 ± 3.0	10.0 ± 3.0
Hancock II	Stented porcine	21		14.8 ± 4.1	1.3 ± 0.4
		23	34.0 ± 13.0	16.6 ± 8.5	1.3 ± 0.4
		25	22.0 ± 5.3	10.8 ± 2.8	1.6 ± 0.4
		29	16.2 ± 1.5	8.2 ± 1.7	1.6 ± 0.2
Homograft	Homograft valves	?	?	?	?
Intact	Stented porcine	19	40.4 ± 15.4	24.5 ± 9.3
		21	40.9 ± 15.6	19.6 ± 8.1	1.6 ± 0.4
		23	32.7 ± 9.6	19.0 ± 6.1	1.6 ± 0.4
		25	29.7 ± 15.0	17.7 ± 7.9	1.7 ± 0.3
		27	25.0 ± 7.6	15.0 ± 4.5
Ionescu - Shiley	Stented bovine pericardial	17	23.8 ± 3.4		0.9 ± 0.1
		19	19.7 ± 5.9	13.3 ± 3.9	1.1 ± 0.1
		21	26.6 ± 9.0
		23		15.6 ± 4.4
Labcor Santiago	Stented bovine pericardial	19	18.6 ± 5.0	11.8 ± 3.3	1.2 ± 0.1
		21	17.5 ± 6.6	8.2 ± 4.5	1.3 ± 0.1
		23	14.8 ± 5.2	7.8 ± 2.9	1.8 ± 0.2
		25	12.3 ± 3.4	6.8 ± 2.0	2.1 ± 0.3
Labcor Synergy	Stented porcine	21	24.3 ± 8.1	13.3 ± 4.2	1.1 ± 0.3
		23	27.3 ± 13.7	15.3 ± 6.9	1.4 ± 0.4
		25	22.5 ± 11.9	13.2 ± 6.4	1.5 ± 0.4
		27	17.8 ± 7.0	10.6 ± 4.6	1.8 ± 0.5
Medtronic Freestyle	Stentless	19		13.0 ± 3.9
		21		9.1 ± 5.1	1.4 ± 0.3
		23	11.0 ± 4.0	8.1 ± 4.6	1.7 ± 0.5
		25		5.3 ± 3.1	2.1 ± 0.5
		27		4.6 ± 3.1	2.5 ± 0.1
Medtronic Mosaic	Stented porcine	21		14.2 ± 5.0	1.4 ± 0.4
		23	23.8 ± 11.0	13.7 ± 4.8	1.5 ± 0.4
		25	22.5 ± 10.0	11.7 ± 5.1	1.8 ± 0.5
		27		10.4 ± 4.3	1.9 ± 0.1
		29		11.1 ± 4.3	2.1 ± 0.2
Mitroflow	Stented bovine pericardial	19	18.6 ± 5.3	13.1 ± 3.3	1.1 ± 0.2
Prima	Stentless	21	28.8 ± 6.0	13.7 ± 1.9	1.4 ± 0.7
		23	21.5 ± 7.5	11.5 ± 4.9	1.5 ± 0.3
		25	22.1 ± 12.5	11.6 ± 7.2	1.8 ± 0.5
Sorin Pericarbon	Stentless	19	36.5 ± 9.0	28.9 ± 7.3	1.2 ± 0.5
		21	28.0 ± 13.3	23.8 ± 11.1	1.3 ± 0.6
		23	27.5 ± 11.5	23.2 ± 7.6	1.5 ± 0.5
St. Jude Medical	Stentless	21	22.6 ± 14.5	10.7 ± 7.2	1.3 ± 0.6
		23	16.2 ± 9.0	8.2 ± 4.7	1.6 ± 0.6
		25	12.7 ± 8.2	6.3 ± 4.1	1.8 ± 0.5
		27	10.1 ± 5.8	5.0 ± 2.9	2.0 ± 0.3
		29	7.7 ± 4.4	4.1 ± 2.4	2.4 ± 0.6

Normal values for Biological Mitral Valve Prosthesis

Valve	Type	Size (mm)	Peak gradient (mmHg)	Mean gradient (mmHg)	Peak Velocity (m/s)	Pressure half-time (ms)	EOA (cm2)
Biocor	Stentless bioprosthesis 27 13 ± 1
29 14 ± 2.5
31 11.5 ± 0.5
33 12 ± 0.5
Stented pericardial bioprosthesis BioFlo 25 10 ± 2 6.3 ± 1.5 0.1 ± 2
27 9.5 ± 2.6 5.4 ± 1.2 2 ± 0.3
29 5 ± 2.8 3.6 ± 0.2 2.4 ± 1
31 4.0 2.0 2.3
Carpentier - Edwards stented bioprosthesis 27 6 ± 2 1.7 ± 0.3 98 ± 28
29 4.7 2 ± 1.76 ± 92 ± 14 12:27
4.4 31 ± 2 92 ± 1:54 ± 0:15 19
6 33 ± 3 93 ± 12
Carpentier - Edwards pericardial stented Bioprosthesis 27 3.6 1.6 100
29 5:25 2:36 ± 1.67 ± 0.3 110 ± 15
31 4:05 1:53 ± 0.83 ± 0.1 90 ± 11
23 1.0 0.8 80
Hancock I ( or NOS ) stented bioprosthesis 27 10 ± 4 5 ± 2 1.3 ± 0.8
29 7 ± 3 2:46 ± 0.79 115 ± 20 1.5 ± 0.2
31 4 ± 0.86 4.86 ± 1.69 95 ± 17 1.6 ± 0.2
33 3 2 ± 3.87 ± 2 90 ± 12 1.9 ± 0.2
Hancock II stented bioprosthesis 27 2:21 ± 0:14
29 2.77 ± 0:11
31 2.84 ± 0.1
33 3:15 ± 0:22
Hancock pericardial stented bioprosthesis 29 2.61 ± 1:39 1:42 ± 0:14 105 ± 36
31 3:57 1:02 1:51 ± 0:27 ± 81 ± 23
Ionescu - Shiley stented bioprosthesis 25 4.87 ± 1.43 ± 1:08 ± 0:15 93 11
27 3:21 1:31 ± 0:24 ± 0.82 100 ± 28
29 3:22 0:57 ± 1:38 ± 0.2 85 ± 8
31 ± 0.9 1.45 ± 3.63 100 ± 36 00:06
Ionescu - Shiley low profile stented bioprosthesis 29 3:31 1:36 ± 0.96 ± 0.25 80 ± 30
31 2.74 ± 0:37 1:33 ± 0:14 ± 79 15
Stented pericardial bioprosthesis Labcor - Santiago 25 8.7 4.5 97 2.2
27 5.6 ± 2.3 2.8 ± 1.5 85 ± 18 ± 2:12 0:48
29 ± 6.2 2.1 ± 1.3 80 ± 3 34 ± 0.73 2:11
Medtronic Intact Porcine stented bioprosthesis 29 3.5 ± 1.6 ± 0:51 0:22
31 ± 4.2 1.6 ± 1:44 0:26
33 4 ± 1.3 1.4 ± 0:24
35 3.2 ± 1.77 1.3 ± 0.5
Stented bioprosthesis Mitroflow 25 6.9 2.0 90
27 3:07 0.91 ± 1.5 90 ± 20
29 ± 3.5 1.43 ± 1.65 102 ± 21 12:29
31 3.85 ± 0.81 91 ± 1:32 ± 0:26 22
Stentless quadrileaflet bovine pericardial bioprosthesis Stentless 26 2.2 1.7 ± 1.6 103 ± 31 1.7
28 1:58 ± 0.25 1.7 ± 0.6
30 1:42 0:32 ± 2.3 ± 0.4
Wessex stented bioprosthesis 29 3.69 ± 0.61 1.66 ± 83 ± 19 00:17
31 3:31 1:41 ± 0.83 ± 0.25 80 ± 21

Related valve dysfunction in bioprostheses

In Stentless bioprosthesis proximal joint of the prosthesis may loosen , causing blood between aortic wall and valve can come . When valve thrombosis there arises an increase in the gradient and an increase in the back flow (leakage) due to the larger mass, to enable the valve closes slowly.

References

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