Hemodynamic comparison of the carpentier-edwards perimount standard and the perimount magna aortic bioprosthesis

Objectives: The Carpentier-Edwards Perimount Magna (CEPM) was designed for a complete supraannular placement and allows implantation of larger prosthesis when compared to the standard Perimount (CEPS). This study compares the hemodynamic performance of both bioprosthesis in aortic position. Methods: 80 consecutive patients surviving an AVR with either the CEPS valve (n=40) or the CEPM bioprosthesis (n=40) were included in the study. The 11 months echocardiographic studies and hemodynamic parameters were retrospectively reviewed. Results: Demographic and clinical data did not differ between groups. The mean valve size implanted was 21.3±1.7mm (CEPS) vs. 22.2±1.8mm (CEPM), p=0.03. The average postoperative mean pressure gradient was 13.6±5.1mmHg in the CEPS group and 9.6±3.3mmHg in the CEPM group (p<0.0001). Mean and peak gradients for the CEPM were slightly lower than for the comparable standard valves, this difference was significant for the 21 and 23mm valves. The effective orifice areas for the Magna were higher than for the comparable CEPS valves: 19mm (1.58±0.2 vs. 1.28±0.1cm 2 ), 21mm (1.90±0.4 vs. 1.69±0.4cm 2 ), 23mm (2.07±0.3 vs. 1.86±0.3cm 2 ), 25mm (2.30±0.1 vs. 1.89±0.5cm 2 ). The average indexed EOA was statistically different between groups (CEPS 0.98±0.21cm 2 /m 2 vs. CEPM 1.20±0.25cm 2 /m 2 ). Patient-prosthesis mismacht (IEOA ≤ 0.85cm 2 /m 2 ) was present in 40.7% (Standard) vs. 16.6% (Magna) of the patients with valve sizes ≤21mm. Conclusion: The hemodynamic performance of CEPM bioprosthesis are substantially better than those of the standard model. Magna bioprosthesis achieved lower gradients and greater IEOA in all valve sizes. The CEPM bioprosthesis significantly reduced the incidence of patient-prosthesis mismatch when compared to the CEPS.