Assessment of the St. Jude Medical Regent Prosthetic Valve by Continuous-Wave Doppler and Dobutamine Stress Echocardiography
Assessment of the St. Jude Medical Regent Prosthetic Valve by Continuous-Wave Doppler and Dobutamine Stress Echocardiography
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DOI：
10.1016/j.athoracsur.2009.09.013
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发表时间：
2010-01-01
影响因子：
4.6
通讯作者：
Minami, Kazutomo
中科院分区：
文献类型：
--
作者：
Sezai, Akira;Kasamaki, Yuji;Minami, Kazutomo
背景圣犹达医疗用品有限公司（SJM）Regent人工瓣膜（圣保罗，MN）是一种最近开发的机械瓣膜，是对传统SJM瓣膜的改进，具有比SJM HP瓣膜更宽的瓣膜面积。我们用多普勒超声心动图和多巴酚丁胺负荷超声心动图（DSE）对该机械瓣膜进行了评价。对58例主动脉瓣置换术后稳定期内应用连续波多普勒超声心动图和DES评价SJM Regent瓣膜的功能。尺寸为17、19、21和23 mm的置换瓣膜的峰值压差分别为27.5 +/- 11.1、20.0 +/- 9.8、15.6 +/- 5.7和14.3 +/- 9.1 mm Hg，有效瓣口面积指数分别为0.97 +/- 0.32、1.01 +/- 0.29，分别为1.09 +/- 0.30和1.41 +/- 0.54 cm（2）/m（2），17、19、21和23 mm瓣膜分别有1、3、2和0例假体-患者不匹配（PPM），总发生率为10.3%。20例患者DSE时的最大跨瓣压差和有效瓣口面积指数较静息时明显增加。虽然PPM的发生率为6.6%，但从DSE和临床症状的数据来看，此类PPM病例在术后早期和中期不存在临床问题。特别是，证明了17 mm和19 mm瓣膜在主动脉瓣环较小患者中的有效性，证实了SJM Regent人工瓣膜的功能令人满意。(Ann Thorac Surg 2010; 89：87-92）（C）2010年，胸外科医师协会ADPENDRIAC
Background. The St. Jude Medical (SJM) Regent prosthetic valve (St. Paul, MN), a recently developed mechanical valve, is an improvement on the conventional SJM valve, having a wider valve area than the SJM HP valve. We evaluated this mechanical valve by Doppler echocardiography and dobutamine stress echocardiography (DSE).Methods. The functions of the SJM Regent valve were evaluated by continuous-wave Doppler echocardiography and DES in 58 cases of aortic valve replacement during a stable postoperative period.Results. The peak pressure gradient of the replaced valves sized 17, 19, 21, and 23 mm was 27.5 +/- 11.1, 20.0 +/- 9.8, 15.6 +/- 5.7, and 14.3 +/- 9.1, mm Hg respectively, and the effective orifice area index was 0.97 +/- 0.32, 1.01 +/- 0.29, 1.09 +/- 0.30, and 1.41 +/- 0.54 cm(2)/m(2), respectively, with prosthesis-patient mismatch (PPM) found in 1, 3, 2, and 0 cases for the 17-, 19-, 21- and 23-mm valves, respectively, with a total incidence of 10.3%. In 20 cases, the peak pressure gradient and the effective orifice area index were significantly increased during DSE compared with those at rest.Conclusions. Although the PPM incidence was 6.6%, it was deemed from the data of DSE and clinical symptoms that there were no clinical issues for such cases of PPM in the early and intermediate phases after operation. Particularly, the effectiveness of the 17- and 19- mm valves in patients with a small aortic annulus was demonstrated, confirming the satisfactory functions of the SJM Regent prosthetic valve. (Ann Thorac Surg 2010; 89: 87-92) (C) 2010 by The Society of Thoracic Surgeons ADULT CARDIAC