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==Biological prosthetic valves== | ==Biological prosthetic valves== | ||
{| class="wikitable" cellpadding="0" cellspacing="0" border="0" | {| class="wikitable" cellpadding="0" cellspacing="0" border="0" width="800px" | ||
|- | |- | ||
|+ Normal values for Biological Aortic Valve Prosthesis | |+ Normal values for Biological Aortic Valve Prosthesis<cite>1</cite> | ||
|- | |- | ||
!Valve | !Valve | ||
Line 10: | Line 10: | ||
!Peak gradient (mmHg) | !Peak gradient (mmHg) | ||
!Mean gradient (mmHg) | !Mean gradient (mmHg) | ||
!EOA ( | !EOA (cm2) | ||
|- | |- | ||
|rowspan="5" valign="top"|Baxter Perimount | |rowspan="5" valign="top"|Baxter Perimount | ||
Line 126: | Line 126: | ||
|19 | |19 | ||
|34.1 ± 2.7 | |34.1 ± 2.7 | ||
| | |||
|1.1 ± 0.1 | |1.1 ± 0.1 | ||
|- | |- | ||
Line 151: | Line 152: | ||
|rowspan="5" valign="top"|Stentless | |rowspan="5" valign="top"|Stentless | ||
|19 | |19 | ||
| | |||
|9.0 ± 2.0 | |9.0 ± 2.0 | ||
|1.5 ± 0.3 | |1.5 ± 0.3 | ||
|- | |- | ||
|21 | |21 | ||
| | |||
|6.6 ± 2.9 | |6.6 ± 2.9 | ||
|1.7 ± 0.4 | |1.7 ± 0.4 | ||
|- | |- | ||
|23 | |23 | ||
| | |||
|6.0 ± 2.3 | |6.0 ± 2.3 | ||
|2.3 ± 0.2 | |2.3 ± 0.2 | ||
|- | |- | ||
|25 | |25 | ||
| | |||
|6.1 ± 2.6 | |6.1 ± 2.6 | ||
|2.6 ± 0.2 | |2.6 ± 0.2 | ||
|- | |- | ||
|27 | |27 | ||
| | |||
|4.0 ± 2.4 | |4.0 ± 2.4 | ||
|2.8 ± 0.3 | |2.8 ± 0.3 | ||
Line 197: | Line 203: | ||
|18.0 ± 6.0 | |18.0 ± 6.0 | ||
|12.0 ± 2.0 | |12.0 ± 2.0 | ||
| | |||
|- | |- | ||
|23 | |23 | ||
|16.0 ± 2.0 | |16.0 ± 2.0 | ||
|11.0 ± 2.0 | |11.0 ± 2.0 | ||
| | |||
|- | |- | ||
|25 | |25 | ||
|15.0 ± 3.0 | |15.0 ± 3.0 | ||
|10.0 ± 3.0 | |10.0 ± 3.0 | ||
| | |||
|- | |- | ||
|rowspan="4" valign="top"|Hancock II | |rowspan="4" valign="top"|Hancock II | ||
|rowspan="4" valign="top"|Stented porcine | |rowspan="4" valign="top"|Stented porcine | ||
|21 | |21 | ||
| | |||
|14.8 ± 4.1 | |14.8 ± 4.1 | ||
|1.3 ± 0.4 | |1.3 ± 0.4 | ||
Line 239: | Line 249: | ||
|40.4 ± 15.4 | |40.4 ± 15.4 | ||
|24.5 ± 9.3 | |24.5 ± 9.3 | ||
| | |||
|- | |- | ||
|21 | |21 | ||
Line 258: | Line 269: | ||
|25.0 ± 7.6 | |25.0 ± 7.6 | ||
|15.0 ± 4.5 | |15.0 ± 4.5 | ||
| | |||
|- | |- | ||
|rowspan="4" valign="top"|Ionescu - Shiley | |rowspan="4" valign="top"|Ionescu - Shiley | ||
Line 355: | Line 367: | ||
|rowspan="5" valign="top"|Stented porcine | |rowspan="5" valign="top"|Stented porcine | ||
|21 | |21 | ||
| | |||
|14.2 ± 5.0 | |14.2 ± 5.0 | ||
|1.4 ± 0.4 | |1.4 ± 0.4 | ||
Line 369: | Line 382: | ||
|- | |- | ||
|27 | |27 | ||
| | |||
|10.4 ± 4.3 | |10.4 ± 4.3 | ||
|1.9 ± 0.1 | |1.9 ± 0.1 | ||
|- | |- | ||
|29 | |29 | ||
| | |||
|11.1 ± 4.3 | |11.1 ± 4.3 | ||
|2.1 ± 0.2 | |2.1 ± 0.2 | ||
Line 445: | Line 460: | ||
|} | |} | ||
{| class="wikitable" cellpadding="0" cellspacing="0" border="0" | {| class="wikitable" cellpadding="0" cellspacing="0" border="0" width="800px" | ||
|- | |||
|+ Normal values for Biological Mitral Valve Prosthesis<cite>1</cite> | |||
|- | |||
!Valve | |||
!Type | |||
!Size (mm) | |||
!Peak gradient (mmHg) | |||
!Mean gradient (mmHg) | |||
!Peak Velocity (m/s) | |||
!Pressure half-time (ms) | |||
!width="100px"|EOA (cm2) | |||
|- | |||
|rowspan="4" valign="top"|Biocor | |||
|rowspan="4" valign="top"|Stentless bioprosthesis | |||
|27 | |||
|13 ± 1 | |||
| | |||
| | |||
| | |||
| | |||
|- | |- | ||
| | |29 | ||
|14 ± 2.5 | |||
| | |||
| | |||
| | |||
| | |||
|- | |||
|31 | |||
|11.5 ± 0.5 | |||
| | |||
| | |||
| | |||
| | |||
|- | |- | ||
| | |33 | ||
|12 ± 0.5 | |||
| | |||
| | |||
| | |||
Stented | | | ||
27 9.5 ± 2.6 5.4 ± 1.2 2 ± 0.3 | |- | ||
29 5 ± 2.8 3.6 ± | |rowspan="4" valign="top"|Bioflo pericardial | ||
31 4.0 2.0 2.3 | |rowspan="4" valign="top"|Stented bioprosthesis | ||
Carpentier - Edwards | |25 | ||
29 4.7 2 | |10 ± 2 | ||
4.4 | |6.3 ± 1.5 | ||
6 | | | ||
Carpentier - Edwards pericardial | | | ||
29 5 | |2 ± 0.1 | ||
31 4 | |- | ||
23 1.0 0.8 80 | |27 | ||
Hancock I ( or NOS ) | |9.5 ± 2.6 | ||
29 7 ± 3 2:46 ± 0.79 115 ± 20 1.5 ± 0.2 | |5.4 ± 1.2 | ||
31 4 ± 0.86 4.86 ± 1.69 95 ± 17 1.6 ± 0.2 | | | ||
33 3 2 | | | ||
Hancock II | |2 ± 0.3 | ||
29 2.77 ± 0 | |- | ||
31 2.84 ± 0.1 | |29 | ||
33 3 | |5 ± 2.8 | ||
Hancock pericardial | |3.6 ± 1 | ||
31 3 | | | ||
Ionescu - Shiley | | | ||
27 3 | |2.4 ± 0.2 | ||
29 3 | |- | ||
31 ± 0.9 1.45 ± | |31 | ||
Ionescu - Shiley low profile | |4.0 | ||
31 2.74 ± 0 | |2.0 | ||
| | |||
27 5.6 ± 2.3 2.8 ± 1.5 85 ± 18 | | | ||
29 | |2.3 | ||
Medtronic Intact Porcine | |- | ||
31 | |rowspan="4" valign="top"|Carpentier - Edwards | ||
33 4 ± 1.3 1.4 ± 0 | |rowspan="4" valign="top"|Stented bioprosthesis | ||
35 3.2 ± 1.77 1.3 ± 0.5 | |27 | ||
Stented bioprosthesis | | | ||
27 3 | |6 ± 2 | ||
29 | |1.7 ± 0.3 | ||
31 3.85 ± 0.81 | |98 ± 28 | ||
Stentless quadrileaflet bovine pericardial bioprosthesis | | | ||
28 1:58 ± 0.25 1.7 ± 0.6 | |- | ||
30 1 | |29 | ||
Wessex | | | ||
31 3 | |4.7 ± 2 | ||
|1.76 ± 0.27 | |||
|92 ± 14 | |||
| | |||
|- | |||
|31 | |||
| | |||
|4.4 ± 2 | |||
|1.54 ± 0.15 | |||
|92 ± 19 | |||
| | |||
|- | |||
|33 | |||
| | |||
|6 ± 3 | |||
| | |||
|93 ± 12 | |||
| | |||
|- | |||
|rowspan="4" valign="top"|Carpentier - Edwards pericardial | |||
|rowspan="4" valign="top"|Stented Bioprosthesis | |||
|27 | |||
| | |||
|3.6 | |||
|1.6 | |||
|100 | |||
| | |||
|- | |||
|29 | |||
| | |||
|5.25 ± 2.36 | |||
|1.67 ± 0.3 | |||
|110 ± 15 | |||
| | |||
|- | |||
|31 | |||
| | |||
|4.05 ± 0.83 | |||
|1.53 ± 0.1 | |||
|90 ± 11 | |||
| | |||
|- | |||
|23 | |||
| | |||
|1.0 | |||
|0.8 | |||
|80 | |||
| | |||
|- | |||
|rowspan="4" valign="top"|Hancock I (or NOS) | |||
|rowspan="4" valign="top"|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 | |||
|- | |||
|rowspan="4" valign="top"|Hancock II | |||
|rowspan="4" valign="top"|Stented bioprosthesis | |||
|27 | |||
| | |||
| | |||
| | |||
| | |||
|2.21 ± 0.14 | |||
|- | |||
|29 | |||
| | |||
| | |||
| | |||
| | |||
|2.77 ± 0.11 | |||
|- | |||
|31 | |||
| | |||
| | |||
| | |||
| | |||
|2.84 ± 0.1 | |||
|- | |||
|33 | |||
| | |||
| | |||
| | |||
| | |||
|3.15 ± 0.22 | |||
|- | |||
|rowspan="2" valign="top"|Hancock pericardial | |||
|rowspan="2" valign="top"|Stented bioprosthesis | |||
|29 | |||
| | |||
|2.61 ± 1:39 | |||
|1:42 ± 0:14 | |||
|105 ± 36 | |||
| | |||
|- | |||
|31 | |||
| | |||
|3.57 ± 1.02 | |||
|1.51 ± 0.27 | |||
|81 ± 23 | |||
| | |||
|- | |||
|rowspan="4" valign="top"|Ionescu - Shiley | |||
|rowspan="4" valign="top"|Stented bioprosthesis | |||
|25 | |||
| | |||
|4.87 ± 1.08 | |||
|1.43 ± 0.15 | |||
|93 ± 11 | |||
| | |||
|- | |||
|27 | |||
| | |||
|3.21 ± 0.82 | |||
|1.31 ± 0.24 | |||
|100 ± 28 | |||
| | |||
|- | |||
|29 | |||
| | |||
|3.22 ± 0.57 | |||
|1.38 ± 0.2 | |||
|85 ± 8 | |||
| | |||
|- | |||
|31 | |||
| | |||
|3.63 ± 0.9 | |||
|1.45 ± 0.06 | |||
|100 ± 36 | |||
| | |||
|- | |||
|rowspan="2" valign="top"|Ionescu - Shiley low profile | |||
|rowspan="2" valign="top"|Stented bioprosthesis | |||
|29 | |||
| | |||
|3.31 ± 0.96 | |||
|1.36 ± 0.25 | |||
|80 ± 30 | |||
| | |||
|- | |||
|31 | |||
| | |||
|2.74 ± 0.37 | |||
|1.33 ± 0.14 | |||
|79 ± 15 | |||
| | |||
|- | |||
|rowspan="3" valign="top"|Labcor-Santiago pericardial | |||
|rowspan="3" valign="top"|Stented bioprosthesis | |||
|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 | |||
|3 ± 1.3 | |||
| | |||
|80 ± 34 | |||
|2.11 ± 0.73 | |||
|- | |||
|rowspan="4" valign="top"|Medtronic Intact Porcine | |||
|rowspan="4" valign="top"|Stented bioprosthesis | |||
|29 | |||
| | |||
|3.5 ± 0.51 | |||
|1.6 ± 0.22 | |||
| | |||
| | |||
|- | |||
|31 | |||
| | |||
|4.2 ± 1.44 | |||
|1.6 ± 0.26 | |||
| | |||
| | |||
|- | |||
|33 | |||
| | |||
|4 ± 1.3 | |||
|1.4 ± 0.24 | |||
| | |||
| | |||
|- | |||
|35 | |||
| | |||
|3.2 ± 1.77 | |||
|1.3 ± 0.5 | |||
| | |||
| | |||
|- | |||
|rowspan="4" valign="top"|Mitroflow | |||
|rowspan="4" valign="top"|Stented bioprosthesis | |||
|25 | |||
| | |||
|6.9 | |||
|2.0 | |||
|90 | |||
| | |||
|- | |||
|27 | |||
| | |||
|3.07 ± 0.91 | |||
|1.5 | |||
|90 ± 20 | |||
| | |||
|- | |||
|29 | |||
| | |||
|3.5 ± 1.65 | |||
|1.43 ± 0.29 | |||
|102 ± 21 | |||
| | |||
|- | |||
|31 | |||
| | |||
|3.85 ± 0.81 | |||
|1.32 ± 0.26 | |||
|91 ± 22 | |||
| | |||
|- | |||
|rowspan="3" valign="top"|Stentless quadrileaflet bovine pericardial | |||
|rowspan="3" valign="top"|Stentless bioprosthesis | |||
|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 | |||
|- | |||
|rowspan="2" valign="top"|Wessex | |||
|rowspan="2" valign="top"|Stented bioprosthesis | |||
|29 | |||
| | |||
|3.69 ± 0.61 | |||
|1.66 ± 0.17 | |||
|83 ± 19 | |||
| | |||
|- | |||
|31 | |||
| | |||
|3.31 ± 0.83 | |||
|1.41 ± 0.25 | |||
|80 ± 21 | |||
| | |||
|} | |} | ||
Related valve dysfunction in bioprostheses | ==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. | |||
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== | ==References== |
edits