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

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. 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. 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. 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.

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© The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.