Hemodynamic performance
As mentioned above, we observed a significant reduction in the peak and
mean gradients of the aortic valve both in the immediate postoperative
period and in the follow-up (Figure2A, Table 3). In the follow up, the
medians of the peak and mean gradients were 14mmHg, (CI95%=10.9-17.6)
and 7mmHg (CI95%=5.2-9.1), respectively. Regarding this matter, Krane
et al. report a mean pressure gradient of 8.9 ± 3.8mmHg at discharge,
which remained stable within the first postoperative year, Ozaki et al.
report a mean peak gradient of 15.2 ± 6.3 mmHg on average 8 years after
surgery. Similar results have been observed in other
series.10,18,21-23
This excellent hemodynamic performance is the result of preserving the
natural motion of the aortic valve annulus and the coordination of the
left ventricle, aortic annulus, sinus of Valsalva, and aorta. This is
particularly important in patients with a small AV
annulus.10,18,26