An echocardiographic evaluation of porcine bioprosthesis

Abstract

Complications related to glutalaldehyde preserved porcine bioprbstheses, such as thromboembolism and valvular dysfunction due to degenerative changes of valvular tissue propose problems for postoperative results of valve replacements, though the incidences are less when compared to that of mechanical prostheses.
Ultrasonic cardiography (UCG) and ultrasonic tomocardiography (UCT) were applied for 14 patients bearing Angell-Shiley (A-S) and H ancock (H) prostheses in mitral or aortic positions for the purpose of early and noninvasive diagnoses of the thrombus formation or valvular dysfunction.
Echocardiogram of bioprosthetic leaflets were recorded more clearly in A-S prostheses than H prostheses. Incidence of visualization was 100% in A-S prostheses and 60% in H prostheses both in mitral position and 0% in A-S prostheses in aortic position. The motions of the leaflets of the bioprostheses in mitral position were well recorded from apical portion in all cases, however they were not well visualized with UCT in the opening phase. Left atrial dimension index (LADI), which is presumed to represent left atrial volume or pressure overloading, were measured. Mean values of LADI were 33.7±5.1mm/sq M in A-S and 33.0±4.5mm/sq M in H prostheses preoperatively. Postoperative values were 29.5±6.0mm/sq M in A-S and 24.6±3.5mm/sq M in H prostheses, showing significantly higher decrement of LADI in H prostheses than A-S prostheses.