A Controlled Trial Comparing One-Year Hemodynamics of Two Bovine Pericardial Valves

Suk Ho Sohn; Yoonjin Kang; Ji Seong Kim; Jae Woong Choi; Jae Hang Lee; Jun Sung Kim; Cheong Lim; Ho Young Hwang

doi:10.1055/a-2199-2087

The Thoracic and Cardiovascular Surgeon, Table of Contents

Thorac Cardiovasc Surg 2025; 73(02): 132-140
DOI: 10.1055/a-2199-2087

Original Cardiovascular

A Controlled Trial Comparing One-Year Hemodynamics of Two Bovine Pericardial Valves

Suk Ho Sohn

¹Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea

,

Yoonjin Kang

¹Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea

,

Ji Seong Kim

¹Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea

,

Jae Woong Choi

¹Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea

,

Jae Hang Lee

²Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea

,

Jun Sung Kim

²Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea

,

Cheong Lim^*

²Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea

,

Ho Young Hwang^*

¹Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea

› Author Affiliations

Abstract

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Abstract

Background This randomized controlled trial was designed to compare 1-year hemodynamic performances and clinical outcomes after aortic valve replacement (AVR) using a recently introduced (the AVALUS group) and worldwide used (the CEPME group) bovine pericardial bioprostheses.

Methods Patients were screened to enroll 70 patients in each group based on a noninferiority design. The primary endpoint of the trial was the mean pressure gradient across the aortic valve (AVMPG) at 1 year after surgery. One-year echocardiographic data were obtained from 92.1% (129 of 140 patients) of the study patients.

Results There were no differences in baseline characteristics, including sex and body surface area (1.64 ± 0.18 vs. 1.65 ± 0.15 m²) between the groups. The AVMPG on 1-year echocardiography was 14.0 ± 4.3 and 13.9 ± 5.1 mmHg in the AVALUS and CEPME groups, respectively (the p-value for noninferiority was 0.0004). In the subgroup analyses for the respective size of the prostheses, AVMPG of the 19-mm prostheses was significantly lower in the AVALUS group than in the CEPME group (14.0 ± 4.3 vs. 20.0 ± 4.7 mmHg, p = 0.012), whereas those of the other sizes were not significantly different between the two groups. There were no significant differences in the effective orifice area (1.49 ± 0.40 vs. 1.53 ± 0.38 cm², p = 0.500) or effective orifice area index (0.91 ± 0.22 vs 0.93 ± 0.23 cm²/m², p = 0.570) in all the patients, or in the subgroup analysis for the 19-mm prosthesis. There were no differences in the 1-year clinical outcomes between the two groups.

Conclusion The 1-year hemodynamic and clinical outcomes of the AVALUS group were noninferior to those of the CEPME group (NCT03796442).

Keywords

aortic valve replacement - bioprosthesis - outcome - hemodynamics

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References

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Supplementary Material

Supplementary Material