Mid-Term Results of Aortic Valve Replacement with Novel “Central Torrent” Mechanical Prosthesis

Vladlen Bazylev ¹, Eugeny Nemchenko ¹, Alisher Gamzaev ², Igor Chernov ³, Andrey Molchanov ⁴, Valery Tsehanovich ⁵, Dmitry Drobot ⁶, Alexander Bogachev-Prokofyev ⁷, Dmitry Ananyev ⁸

¹ The Federal State Government-financed Establishment FEDERAL CENTER OF CARDIOVASCULAR SURGERY of the Ministry of Healthcare of Russian Federation (Penza), Penza, Russia; ² Nizhny Novgorod SCCH, Nizhny Novgorod , Russia; ³ Astrakhan FCCVS, Astrakhan , Russia; ⁴ Ekaterinburg SRCH, Ekaterinburg , Russia; ⁵ Omsk RCH, Omsk , Russia; ⁶ Krasnoyarsk FCCVS, Krasnoyarsk FCCVS, Russia; ⁷ Novosibirsk NMRC, Novosibirsk , Russia; ⁸ Barnaul RCH, Barnaul , Russia;

Date, time and location: 2018.05.26 08:30, Congress Hall, 2F–B

Abstract

OBJECTIVE: In contrast to ordinary bileaflet mechanical prosthetic heart valves, leaflets in the

new generation “central torrent” prosthesis in open position are allocated along the inner wall of

its body, forming one almost round orifice. The aim of this study was to analyze mid-term results

of aortic valve replacement (AVR) with “MEDENG-CT”, the first clinically approved “central

torrent” prostheses.

METHODS: Between 2012 and 2017, 154 consequent patients fulfilling inclusion criteria

underwent isolated AVR with “MEDENG-CT” mechanical prostheses in 8 Russian centers.

Clinical data were obtained preoperatively, perioperatively and at discharge. Then mid-term data

were obtained during annual follow-up visits and included blood studies, echocardiography and

examination by the physician.

RESULTS: Mean follow-up time was 25 months (295 pt-yrs), and maximal follow-up time was

61 months. Operative (thirty-day) mortality was 5.8% (9 patients, not valve related). Late

mortality was 0.7%/pt-yrs (1 patient died 4 months post-op, non-cardiac death; 1 patient died 2.5

months post-op during non-cardiac bypass surgery). There were neither reoperations nor cases of

structural dysfunctions, thromboses, pannus formations or major bleedings. There were 3

embolic events (1.9%) in the thirty-day period and 3 late embolic events (1.0%/pt-yrs). Mean

gradient after AVR was 8.5±3.0 mmHg. Peak gradient after AVR was 16.8±5.6 mmHg. INR for

52% of patients was below the recommended level (2.5 – 3.0).

CONCLUSION: “Central torrent” bileaflet mechanical prosthetic heart valve “MEDENG-CT”

shows good mid-term clinical and hemodynamic results even for patients with INR below the

recommended level.