DK2985_C000 1..28 - AlSharqia Echo Club

Evaluation of Aortic Valve Surgery 369Table 16.3Normal Reference Values of Effective Orifice Areas for the Prosthetic ValvesProsthetic valve size (mm)19 21 23 25 27 29 ReferenceStented bioprosthetic valvesMedtronic Mosaic 1.20 1.22 1.38 1.65 1.80 2.00 (13)Hancock II – 1.18 1.33 1.46 1.55 1.60 (7)Carpentier–Edwards Perimount 1.10 1.30 1.50 1.80 1.80 – (7)Stentless bioprosthetic valvesMedtronic Freestyle 1.15 1.35 1.48 2.00 2.32 – (7)St. Jude Medical Toronto SPV – 1.30 1.50 1.70 2.00 2.50 (7)Prima Edwards 0.80 1.10 1.50 1.80 2.30 2.80Mechanical valves (14)Medtronic–Hall 1.19 1.34 – – – – (15)St. Jude Medical Standard 1.04 1.38 1.52 2.08 2.65 3.23 (7)St. Jude Medical HP 1.30 2.01 – – – – (16,17)St. Jude Medical Regent 1.60 2.00 2.20 2.50 3.60 4.40 (18)MCRI On-X 1.50 1.70 2.00 2.40 3.20 3.20 (19)Carbomedics 1.00 1.54 1.63 1.98 2.41 2.63 (7)Sorin Bicarbon – 1.66 1.96 – – – (20)Note: Effective orifice area is expressed as mean values available in the literature.Source: Reproduced and modified with permission from Cardiac Surgery Today (12).(EOA ,0.65 cm 2 /m 2 ) mismatch have a much greater riskof not surviving the perioperative period than patientswithout these characteristics. Recently reported datafrom the Quebec Heart Institute/Laval Hospital (10) in aseries of 1266 consecutive patients undergoing AoV replacementalso show a perioperative mortality of 67% inpatients with the combined evidence of severe mismatchand an ejection fraction ,40% compared with 3% inpatients with no mismatch and ejection fraction .40%,intermediate mortality rates being observed in the otherMORTALITY RATE (%)80706050403020100PATIENT-PROSTHESIS MISMATCHLVEF