CARDIOVASCULAR SURGERY

Clinical and echocardiographic assessment of the Medtronic Advantage aortic valve prosthesis: the Scandinavian multicentre, prospective study

Rune Haaverstad¹, Nicola Vitale¹, Asbjørn Karevold¹, Giangiuseppe Cappabianca¹, Arve Tromsdal¹, Peter Skov Olsen², Lars Köber², Halfdan Ihlen³, Kjell Arne Rein³, Jan L Svennevig³

¹ Departments of Cardiothoracic Surgery, Trondheim University Hospital, Trondheim, Norway
² Departments of Cardiothoracic Surgery, Rigshospitalet, Copenhagen, Denmark
³ Departments of Cardiothoracic Surgery, Rikshospitalet, Oslo, Norway

Correspondence to:
Professor R Haaverstad
St Elisabeth Cardiothoracic Centre, Trondheim University Hospital, N 7018 Trondheim, Norway; rune.haaverstad{at}ntnu.no

Objective: The aim of this report is the prospective, multicentre evaluation of clinical results and haemodynamic performance of the Medtronic Advantage aortic valve prosthesis.

Methods: From April 2001 to June 2003, 166 patients (male:female 125:41; mean (SD) age 61.8 (11.8) years) received an aortic advantage valve prosthesis. Complete cumulative follow-up was 242.7 patient-years (maximum 3.2; mean 1.6 years). Postoperatively, patients underwent early (within 30 days) and 1 year transthoracic echocardiography.

Results: 30 day mortality was 2.4% (n = 4). Kaplan–Meier estimates of freedom from complications and linearised rates were as follows: 96.9 (1.6)% survival; 94.7 (1.3)% (2.06 patients/year) thrombo-embolism; 99.4 (0.6)% (0.4 patients/year) bleeding; 98.8 (0.9)% (0.8 patients/year) non-structural valve dysfunction; 98.8 (0.9)% (0.8 patients/year) reoperation. Valvular mean pressure gradients ranged from 16 (3) mm Hg for size 19 to 7 (2) mm Hg for size 27 and the corresponding effective orifice areas ranged from 1.2 (0.25) to 3.2 (0.66) cm². In all, left ventricular mass significantly decreased (p<0.001) and fractional shortening increased (p<0.001) from postoperative to 1 year echocardiography.

Conclusions: Haemodynamic performance and early clinical results of Medtronic advantage in the aortic position were satisfactory and comparable with those of other bileaflet valves in current clinical use.

Abbreviations: EOA, effective orifice area; EOAI, effective orifice area index; INR, international normalised ratio; LVM, left ventricular mass; LVOT, left ventricular outflow tract; NYHA, New York Heart Association; PI_LVOT, performance index calculated using the left ventricular outflow tract area; PI_TAA, performance index calculated using the tissue annulus area

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This article has been cited by other articles:

• Haaverstad, R., Vitale, N., Tromsdal, A., Hegbom, K., Karevold, A. (2007). Intermittent incomplete closure of Medtronic Advantage aortic valve leaflets causes unnecessary reoperation. J. Thorac. Cardiovasc. Surg. 134: 791-792 [Full Text]