The Annals of Thoracic Surgery, Vol 30, 455-464, Copyright © 1980 by The Society of Thoracic Surgeons
Clinical and hemodynamic assessment of the Angell-Shiley porcine xenograft
R Rivera, C Infantes, JL Delcan and M Rico
Valve replacement with an Angell-Shiley bioprosthesis was accomplished in
449 patients. To evaluate the bioprostheses from this total series, 344
patients who did not undergo associated operation, had no previous
operations, or had no other valve substitutes were selected. Hospital
mortality was 2.6% for aortic (4 out of 156), 7.2% for mitral (9 out of
125), and 12.7% for multiple-valve replacements (8 out of 63). The 323
patients discharged from the hospital were followed for 6 to 36 months.
There were 15 late deaths. Hepatitis, bleeding, thromboembolism,
endocarditis, and residual valvular incompetence, always periprosthetic,
were the major complications. Forty-five patients with single-valve
replacement (16 mitral and 29 aortic) without clinical valve dysfunction
were electively recatheterized to assess hemodynamic performance.
Measurements were recorded at rest and during exercise on a bicycle
ergometer. Functional aortic valve orifice averaged 1.23 +/- 0.33 cm2 and
the mean systolic gradient was 21.51 +/- 6.68 mm Hg at rest. During
exercise, aortic gradient increased to 26.60 +/- 7.54 mm Hg and mean
functional area to 1.51 +/- 0.34 cm2. In the mitral position, the mean
diastolic gradient at rest was 8.44 +/- 3.17 mm Hg and the functional
orifice area averaged 1.67 +/- 0.51 cm2. Exercise increased the mean
gradient to 11.92 +/- 3.8 mm Hg and the mean orifice area to 2.05 +/- 0.57
cm2.
