Examining the typical hemodynamic performance of nearly 3000 modern surgical aortic bioprostheses.

OBJECTIVES:The objective of this analysis was to assess the normal haemodynamic performance of contemporary surgical aortic valves at 1 year postimplant in patients undergoing surgical aortic valve replacement (SAVR) for significant valvular dysfunction. By pooling data from four multicentre studies, this study will contribute to a better understanding of the effectiveness of SAVR procedures, aiding clinicians and researchers in making informed decisions regarding valve selection and patient management. METHODS:Echocardiograms were assessed by a single core laboratory. Effective orifice area (EOA), dimensionless velocity index (DVI), mean aortic gradient, peak aortic velocity, and stroke volume were evaluated. RESULTS:The cohort included 2958 patients. Baseline age in the studies ranged from 70.1 ± 9.0 to 83.3 ± 6.4 years, and STS risk of mortality was 1.9 ± 0.7 to 7.5 ± 3.4%. Twenty patients who had received a valve model implanted in fewer than 10 cases were excluded. Ten valve models (all tissue valves; N = 2938 patients) were analyzed. At 1 year, population mean EOA ranged from 1.46 ± 0.34 to 2.12 ± 0.59 cm2, and DVI, from 0.39 ± 0.07 to 0.56 ± 0.15. The mean gradient ranged from 8.6 ± 3.4 to 16.1 ± 6.2 mmHg with peak aortic velocity of 1.96 ± 0.39 to 2.65 ± 0.47 m/s. Stroke volume was 75.3 ± 19.6 to 89.8 ± 24.3 mL. CONCLUSIONS:This pooled cohort is the largest to date of contemporary surgical aortic valves with echocardiograms analyzed by a single core lab. Overall haemodynamic performance at 1 year ranged from good to excellent. These data can serve as a benchmark for other studies and may be useful to evaluate the performance of bioprosthetic surgical valves over time.