The Journal of Thoracic and Cardiovascular Surgery, Vol 82, 601-607, Copyright © 1981 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Hemodynamic function of the Hancock standard orifice aortic valve bioprosthesis
AM Borkon, CL McIntosh, M Jones, LC Lipson, KM Kent and AG Morrow
Reports that the hemodynamic performance of the standard orifice aortic
bioprosthesis in less than optimal have prompted recommendations that
mechanical prosthesis or anulus-enlarging procedures be used in adult
patients with a small aortic root. The hemodynamic function of the Hancock
bioprosthesis was evaluated in 77 patients who underwent cardiac
catheterization of rest and with isoproterenol infusion (15 patients) an
average of 6 months after operation. The average peak systolic gradient
(basal conditions) was 7 mm Hg (range 0 to 37 mm Hg); 35 patients had no
resting gradient. Fifteen patients received 21 mm diameter valves and had
an average systolic valve gradient of 10 mm Hg (range 0 to 30 mm Hg); the
average effective valve orifice area was 1.27 +/- 0.17 cm2 for 21 mm, 1.46
+/- 0.11 cm2 for 23 mm, 1.72 +/- k0.20 cm2 for 25 mm, and 1.97 +/- 0.06 for
27 mm bioprostheses. Isoproterenol infusion, elevating cardiac output 66%,
increased the peak systolic gradient from an average of 11 mm Hg (range 0
to 37 mm Hg) to 44 mm Hg (range 10 to 85 mm Hg). It is concluded that
small- diameter (21 and 23 mm) Hancock bioprostheses can be used with
acceptable clinical and hemodynamic function in patients with a small body
surface area.
