Hemodynamic evaluation of 23 mm Pericarbon and 23 mm Hancock II bioprostheses in the aortic position at mid-term follow up.

BACKGROUND AND AIMS OF THE STUDY: Pericardial xenografts were introduced for clinical use following evidence of their good hemodynamic characteristics in laboratory tests; however, their efficiency in comparison with porcine valves has not been fully assessed. Pericarbon, a new type of pericardial bioprosthesis, has been recently developed in order to provide better hemodynamic performances and longer durability than such bioprostheses currently in use. METHODS: Fifteen patients operated on for aortic valve replacement with a 23 mm Pericarbon and a sex- and age-matched group operated on with a 23 mm Hancock II bioprosthesis were submitted to echocardiographic and Doppler examinations in order to compare the hemodynamic performance of the two devices. RESULTS: Peak transvalvular gradients for Pericarbon and Hancock II bioprostheses (38.9 +/- 13.0 vs. 33.9 +/- 13.0 mmHg; p = 0.294) and mean transvalvular gradients (24.7 +/- 7.6 vs. 20.8 +/- 9.9 mmHg, p = 0.24) showed no significant difference. However, the indexed effective prosthetic dynamic area was significantly larger for the Hancock II device (0.73 +/- 0.14 vs. 0.62 +/- 0.13 cm2; p < 0.05). CONCLUSIONS: When installed as 23 mm pericardial bioprostheses, the Pericarbon device appears not to demonstrate superior hemodynamic performance to that of the Hancock II; however, additional studies are needed to provide a definitive conclusion.