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Aortic Valve Replacement Products - Pericardial

Magna Aortic Valve

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Edwards Lifesciences aortic pericardial heart valve replacements ..

Results A total of 1436 patients underwent aortic valve replacement (Trifecta in 196, Mitroflow in 1135, Perimount Magna in 105). Preoperative characteristics and early clinical outcomes were similar among the 3 valve groups. The average mean gradients were lower and valve areas were greater with the Trifecta valves. For the Trifecta, Mitroflow, and Perimount Magna valves, the average mean gradient was 11.4 mm Hg, 16.9 mm Hg, and 14.1 mm Hg, respectively; the effective orifice area was 2.22 cm2, 1.85 cm2, and 2.09 cm2, respectively; and the indexed effective orifice area was 1.14 cm2/m2, 0.96 cm2/m2, and 1.07 cm2/m2, respectively (all P 2/m2) was detected in 1.3% of patients (n = 2/150) with the Trifecta, 5.8% of patients (n = 44/758) with the Mitroflow, and 3.2% of patients (n = 3/95) with the Perimount Magna (P =.048).

Carpentier-Edwards PERIMOUNT Magna aortic valve ..

Transthoracic echocardiograms were performed before discharge and 1 year after surgery in all patients. These early postoperative and 1-year hemodynamic measurements are listed in . A summary of the mean and peak gradients early and at 1 year according to valve size is provided in . The Magna patients had a larger effective orifice area indexed to body surface area (iEOA), both early postoperatively and after 1 year. They also demonstrated lower peak and mean transvalvular gradients at both time periods (). This did not translate into a benefit of left ventricular mass regression, as the mean left ventricular mass regression was not different between groups at 1 year ().

Carpentier-Edwards PERIMOUNT Magna bioprosthesis…

There were 69 patients with aortic valve replacement included in this analysis. The mean implanted labeled valve size (Magna 24.3 ±2.0 mm vs. Epic 24.1 ±2.2 mm) was not different between the groups (p = 0.51). Valves of all sizes for both types were implanted as appropriate. Preoperative patient characteristics were comparable in the two groups and are summarized in . Although aortic stenosis was the main indication for surgery in both groups, the prevalence of senile calcific degeneration of the valve was higher in the Epic group, while the incidence of bicuspid aortic valve disease was significantly higher in the Magna group. Intraoperative variables were similar for the two groups and are summarized in . There was a higher incidence of aortic root enlargement performed in the Magna group. This difference was surgeon dependent and may represent the increased size of the patients in that group.

The main aim of the present study was to compare the early and 1-year echocardiographic hemodynamic performance of a relatively new Epic valve, with that of the Perimount Magna valve by transthoracic echocardiography.

Carpentier-Edwards PERIMOUNT Magna Ease Pericardial Bioprosthesis, ..

Operations were performed using general anesthesia via full median sternotomy using standard cardiopulmonary bypass techniques with mild systemic hypothermia. A transverse aortotomy was performed 1 cm to 2 cm above the right coronary ostium. Cardioplegic arrest was achieved and maintained with cold blood delivered in an antegrade fashion with or without retrograde delivery and was dependent on surgeon preference. The choice of Magna or Epic valve was determined by a combination of surgeon and patient preference. After the native aortic valve was excised, the annulus was measured with the appropriate sizer for the chosen prosthesis. The prosthesis size that would comfortably fit within the aortic annulus was chosen. To avoid prosthesis-patient mismatch, annular enlargement with bovine or autologous pericardium [] was performed to achieve a minimum projected indexed effective orifice area of 0.75 cm2 when the attending surgeon believed the risk was justified. The valves were implanted in the supra-annular position using pledgeted 2-0 braided polyester mattress sutures in a non-everting fashion. In patients requiring concomitant procedures such as coronary bypass grafting or septal myectomy, the appropriate surgical treatment was performed before AVR. Patients with marked ascending aorta dilatation received a supracoronary Dacron tube graft (n = 4).

We retrospectively reviewed all perioperative data entered prospectively into our institutional database from June 2004 to March 2006. A group of 69 consecutive patients was identified who underwent aortic valve replacement (AVR) with either the Magna (n = 33) or the Epic (n = 36) bioprosthesis, with or without concomitant procedures. Patients receiving multiple valve replacements were excluded to reduce bias in echo and clinical interpretation of the data. Ethical approval was granted by our Institutional Research Ethics Board and the need for individual patient consent was waived.

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Carpentier-Edwards PERIMOUNT Magna Mitral Ease Heart Valve

The aim of this study was therefore to compare early postoperative hemodynamic performance of the Magna pericardial and Epic porcine bioprosthesis in the aortic position.

Magna ™ (Magna) aortic pericardial valve ..

The St Jude Medical (SJM) Epic (St Jude Medical Inc, St Paul, MN) Porcine Bioprosthetic heart valve (Epic) is manufactured from selected size-matched porcine aortic valve cusps. Tissue fixation is achieved with a glutaraldehyde solution. This valve is morphologically identical to the previous generation SJM Biocor valve that has been implanted since 1981. Anti-calcification treatment has been incorporated into this valve with the addition of a 95% ethanol solution. For the aortic position, this valve is available in odd millimeter sizes from 21 mm to 29 mm. The valves are mounted on a flexible acetyl copolymer stent with a low profile design and scalloped shape that permits supra-annular placement of the bioprosthesis.

Carpentier-Edwards Perimount Magna Valve Versus …

To achieve improved hemodynamic performance, the Magna valve was designed with a smaller sewing ring [], and the sewing cuff was displaced so that both sewing cuff and leaflets remain in a supra-annular position. This valve incorporates a proprietary anti-calcification treatment called ThermaFix. This includes tissue preservation with glutaraldehyde, followed by heat treatment to remove any unstable bonds between glutaraldehyde and lysine side chains of the collagen. This is followed by the use of alcohol and surfactant to remove any phospholipids within the leaflet structure. They are available in odd millimeter sizes from 19 mm to 29 mm, and are mounted on a cobalt-chromium wire and polyester frame.

The Carpentier-Edwards Perimount Magna valve ..

Our study showed significantly lower transvalvular gradients for patients receiving Magna valves compared with patients receiving similar sized Epic valves. The transvalvular gradient is dependent on flow and EOA, with the EOA related to the internal diameter of the implanted prosthesis. The supra-annular position of prostheses is commonly undertaken when implanting stented tissue valves to maximize the implanted size within a defined tissue annulus dimension []. Stented valves all have a tendency to create higher transvalvular gradients due to obstruction by sewing ring and stents, as well as potentially suboptimal leaflet opening. According to Gerosa and colleagues, who measured the geometric dimensions of five different supra-annular prostheses, comparison between different tissue valves is complicated and sometimes misleading because of the discrepancies between the manufacturer's branded sizing, and the actual internal and external diameters of the respective valves []. This makes it imperative to obtain accurate and clinically relevant data on the hemodynamics and patient outcomes to compare the performances of the valves.

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