Comparative analysis of hemodynamic characteristics of the biological xenogenic pericardial prosthesis MEDINGE-BIO with “easy change” system and the xenogenic aortic prosthesis Hancock II after aortic valve replacement

Aim. To compare the outcomes of aortic valve replacement using the xenogenic aortic prosthesis Hancock II and the novel Russian xenogenic pericardial prosthesis MEDINGE-BIO.

Material and methods. The study included patients operated on for aortic stenosis in the cardiac surgery department № 1 of the Cardiology Research Institute (Tomsk National Research Medical Center). All patients were divided into two groups. The first group included 54 patients with Hancock II prostheses, the second — 91 patients with MEDINGE-BIO prostheses. Hemodynamic characteristics of heart valves were assessed by echocardiography before surgery and before discharge (on average 10 days after surgery).

Results. When comparing hemodynamic parameters before and after surgery, significant differences between the groups were not obtained. The average pressure gradient after surgery using Hancock II and MEDINGE-BIO prosthesis was 21,6±7,9 and 17,9±5,6 mm Hg, respectively (p=0,05).

Conclusion. The comparative analysis showed that the novel biological prosthesis MEDINGE-BIO has comparable hemodynamic characteristics with the well-known aortic prosthesis Hancock II.

1. Baumgartner H, Falk V, Bax JJ, et al.; ESC Scientific Document Group. 2017 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J. 2017;38(36):2739-91. doi:10.1093/eurheartj/ehx391.

2. Otto CM, Nishimura RA, Bonow RO, et al. 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2021;143(5):e35-e71. doi:10.1161/CIR.0000000000000932. Erratum in: Circulation. 2021;143(5):e228. Erratum in: Circulation. 2021;143(10):e784.

3. Harky A, Suen MMY, Wong CHM, et al. Bioprosthetic Aortic Valve Replacement in <50 Years Old Patients — Where is the Evidence? Braz J Cardiovasc Surg. 2019;34(6):729-38. doi:10.21470/1678-9741-2018-0374.

4. Une D, Ruel M, David TE. Twenty-year durability of the aortic Hancock II bioprosthesis in young patients: is it durable enough? Eur J Cardiothorac Surg. 2014;46(5):825-30. doi:10.1093/ejcts/ezu014.

5. Caporali E, Bonato R, Klersy C, et al. Hemodynamic performance and clinical outcome of pericardial Perimount Magna and Porcine Hancock-II valves in aortic position. J Card Surg. 2019;34(10):1055-61. doi:10.1111/jocs.14212.

6. Sellers SL, Blanke P, Leipsic JA. Bioprosthetic Heart Valve Degeneration and Dysfunction: Focus on Mechanisms and Multidisciplinary Imaging Considerations. Radiol Cardiothorac Imaging. 2019;1(3):e190004. doi:10.1148/ryct.2019190004.

7. Beckmann A, Meyer R, Lewandowski J, et al. German Heart Surgery Report 2019: The Annual Updated Registry of the German Society for Thoracic and Cardiovascular Surgery. Thorac Cardiovasc Surg. 2020;68(4):263-76. doi:10.1055/s-0040-1710569.

8. Cardiovascular Surgery — 2019. Bockeria L.A. (ed.). Moscow: N.I. A.N. Bakuleva, Ministry of Health of Russia. 2020. 294 p. (in Russ.) ISBN: 978-5-7982-0420-5.

9. Kozlov BN, Petlin KA, Kosovskikh EA, et al. The results of using the frame xenopericardial bioprosthesis in the aortic position with the “easy change” system 12 months after implantation. Clin Experiment Surg. Petrovsky J. 2020;8(2):45-50. (In Russ.) doi:10.33029/2308-1198-2020-8-2-45-50.