Abstract
The late result and the hemodynamic function of Bicer-val (B-V) prosthesis in the aortic position was evaluated in 30 patients who had aortic valve replacement. The cardiac output and the simultaneous transvalvular gradient were recorded at rest (R) and during exercise (EX). Left ventriculography was performed at R. There was no thromboembolism or late death. The maximum opening angle of the prosthesis was 79±1 degrees. The average aortic mean systolic gradient was 9mmHg at R and 14mmHg during EX in 21mm B-V, 3mmHg at R, 9mmHg during EX in 23mm B-V, 2mmHg at R, 9mmHg during EX in 25mm B-V. The mean effective orifice area was 1.51cm2 at R, 1.79cm2 during EX in 21mm B-V, 4.53cm2 at R and 3.29cm2 during EX in 23mm B-V, 3.29cm2 at R and 2.78cm2 during EX in 25mm B-V. The B-V prosthesis in the aortic position has favorable systolic function when compared with other aortic valve prosthesis currently available. with aortography, aortic regurgitation was mild. However, in one of the 30 consecutive patients, open stuck valve was encountered during operation, successfully managed by 180° rotation of the disc occuluder only. This dangerous complication may occur when the open angle on the prosthesis become large.
