One-year outcomes associated with a novel stented bovine pericardial aortic bioprosthesis

Abstract

This analysis of a new stented bovine pericardial aortic valve demonstrated low overall mortality and valve-related adverse events, and hemodynamic performance comparable to that of other surgical aortic valves.

Prosthesis–patient mismatch definition(s): Let's agree to agree

“…This is an inadvertent incorrect statement as we have previously reported comprehensive differences comparing 2dimensional transthoracic echocardiography (TTE) longaxis root measurements (diastolic leading edge to leading edge) with double-oblique CT-angiography maximum root diameters (diastolic inner wall to inner wall) in patients with BAV. 2 Indeed, we found systematic TTE underestimation of the root by 3.1 AE 2.6 mm by long-axis TTE compared with CT angiography. Therefore, we tested a new mid-diastolic short-axis 2-dimensional transthoracic root measurement method (leading edge to leading edge) ( Figure 1) and found unbiased Bland-Altman agreement between that method and CT angiography (diastolic inner wall to inner wall) for root measurement in patients with BAV.…”

“…In their letter to the editor, Dr Durko and colleagues 1 advocated using the Valve Academic Research Consortium-2 2 adjusted criteria defining prosthesis-patient mismatch (PPM) in obese patients in the PERIGON trial of a novel aortic bioprosthesis. 3 Their letter described a high rate of PPM in PERIGON (62.6% at discharge and 75.5% at 1 year), and they speculated that this may be due to a greater proportion of obese patients being included in the trial.…”

“…Because outcomes in obese patients tend to be less affected by PPM, 5 this has led some to suggest adjusting the definition of PPM in such patients. 2 The Valve Academic Research Consortium-2 guidelines advocating this adjustment were specifically intended for transcatheter valve implantation, but it would make sense for a standard definition to be applied to all types of aortic valves. We have read with great interest the article by Plonek and colleagues, 1 which concludes that aortic root diameters can be underestimated by single-plane long-axis echocardiographic measurements when compared with doubleoblique computed tomography (CT) angiography maximum measurements, particularly in patients with bicuspid aortic valves (BAVs).…”

“…We certainly agree with this important concept. 2 The authors further explain that underestimation of aortic diameters has been analyzed only for abdominal aortic aneurysms, but no study has analyzed the aortic root; therefore, theirs is the first to do so. This is an inadvertent incorrect statement as we have previously reported comprehensive differences comparing 2dimensional transthoracic echocardiography (TTE) longaxis root measurements (diastolic leading edge to leading edge) with double-oblique CT-angiography maximum root diameters (diastolic inner wall to inner wall) in patients with BAV.…”

“…Therefore, we tested a new mid-diastolic short-axis 2-dimensional transthoracic root measurement method (leading edge to leading edge) ( Figure 1) and found unbiased Bland-Altman agreement between that method and CT angiography (diastolic inner wall to inner wall) for root measurement in patients with BAV. 2 In addition, the underestimation of the BAV root by single-plane TTE and the importance of using inner wall to inner wall measurements with CT angiography…”