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Clinical and echocardiographic assessment of the Medtronic Advantage aortic valve prosthesis: the Scandinavian multicentre, prospective study
  1. Rune Haaverstad1,
  2. Nicola Vitale1,
  3. Asbjørn Karevold1,
  4. Giangiuseppe Cappabianca1,
  5. Arve Tromsdal1,
  6. Peter Skov Olsen2,
  7. Lars Köber2,
  8. Halfdan Ihlen3,
  9. Kjell Arne Rein3,
  10. Jan L Svennevig3
  1. 1Departments of Cardiothoracic Surgery, Trondheim University Hospital, Trondheim, Norway
  2. 2Departments of Cardiothoracic Surgery, Rigshospitalet, Copenhagen, Denmark
  3. 3Departments of Cardiothoracic Surgery, Rikshospitalet, Oslo, Norway
  1. Correspondence to:
    Professor R Haaverstad
    St Elisabeth Cardiothoracic Centre, Trondheim University Hospital, N 7018 Trondheim, Norway; rune.haaverstad{at}ntnu.no

Abstract

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.

  • 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
  • PILVOT, performance index calculated using the left ventricular outflow tract area
  • PITAA, performance index calculated using the tissue annulus area

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Footnotes

  • Published Online First 25 October 2006

  • Funding: This study was financially supported by Medtronic. RH and JLS are members of Medtronic Cardiac Surgery and Medical Advisory Boards, respectively.

  • Competing interests: None declared.

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