Key result
Dokimos Plus aortic prosthesis demonstrates satisfactory hemodynamics with ~5% overall mortality.
Why the study?
In patients with a small aortic annulus, AVR is frequently associated with high residual pressure gradients, and supra-annular pericardial aortic prostheses are gaining popularity due to increased EOA and lower gradients.
Does the Dokimos Plus supra-annular pericardial aortic prosthesis provide satisfactory haemodynamic performance in patients undergoing aortic valve replacement?
Observational (n=137)
No
Does the Dokimos Plus supra-annular pericardial aortic prosthesis provide satisfactory haemodynamic performance in patients undergoing aortic valve replacement?
The Dokimos Plus supra-annular pericardial aortic prosthesis demonstrates satisfactory early haemodynamic performance with low gradients and adequate effective orifice areas.
Supports early performance of Dokimos Plus prosthesis; leaves open durability and randomized comparisons.
Objectives: In patients with a small aortic annulus, aortic valve replacement (AVR) is frequently associated with high residual pressure gradients. Supra-annular pericardial aortic prostheses are gaining popularity due to the increased effective orifice areas (EOA) and resulting lower gradients. This study reports the clinical and echocardiographic results following implantation of the new supra-annular pericardial aortic prosthesis Dokimos Plus (Labcor, Belo Horizonte, Brazil). Methods: Between October 2013 and July 2015, 137 patients (41% women, mean age: 74 years) underwent supra-annular AVR with or without concomitant procedures using the Dokimos Plus prosthesis in our department. Transthoracic echocardiography was performed pre- and postoperatively on all patients to assess haemodynamic parameters (gradients, acceleration time [AT], Doppler velocity indices [DVIs] and indexed EOA [EOAI]) and to detect paravalvular leakage (PVL). Data were collected retrospectively from our hospital databases. Methods: Patients were grouped by prosthesis size: Most patients received 23-mm (57.6%), followed by 21-mm (19%), 25-mm (15.4%) and 27-mm (8%) prostheses. The mean EOAI in all groups was 1.1 ± 0.26 cm 2 /m 2 . Pressure gradients were low in all groups (mean: 8.9 ± 4.4 mmHg; peak: 18.8 ± 6.8 mmHg); AT and DVI were in the normal range according to American Society of Echocardiography/European Association of Cardiovascular Imaging recommendations (mean AT 73.3 ± 29 ms; mean DVI 0.5 ± 0.2). One patient had severe PVL and one presented with central regurgitation, both requiring re-intervention. The mortality rate was 5.1% ( n = 7); none of the cases was associated with valve insufficiency. Conclusions: The Dokimos prosthesis showed a satisfactory overall performance, presenting low gradients and DVIs as well as high EOAI. Further investigations are needed to analyse the cases of regurgitation and monitor long-term performance.
No takes yet. Share an insight, caveat, or question.
Zayat et al. (2016) conducted an observational in Aortic valve replacement (n=137). Dokimos Plus pericardial aortic prosthesis was evaluated on Haemodynamic parameters (gradients, acceleration time, Doppler velocity indices, indexed effective orifice area) and paravalvular leakage. The Dokimos Plus pericardial aortic prosthesis demonstrated satisfactory haemodynamic performance with low mean pressure gradients (8.9 mmHg) and an overall mortality rate of 5.1%.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: