Doppler Echocardiographic Assessment of Normally Functioning Starr-Edwards, Carbomedics and Carpentier-Edwards Valves in Aortic Position

Doppler echocardiography was performed in 168 normally functioning aortic prostheses to determine acceptable pressure gradients across the commonly used valves and to establish the relationship between valve size and gradients. There were 82 Carbomedics (C), 63 Starr-Edwards (SE), and 23 Carpentier-Edwards (CE) valves. Peak and mean gradients across the prostheses were measured by use of the simplified Bernoulli equation. CarboMedics valve had a lower peak and mean gradient than Starr-Edwards and Carpentier-Edwards valve (P < 0.05 when compared with Starr-Edwards). The authors observed a weak inverse correlation between valve size and peak and mean gradients in CarboMedics and Carpentier-Edwards valves but not in the Starr-Edwards valve. For the CarboMedics valve the peak pressure gradient (PPG) was 26.1 ±8.2 mm Hg and the mean pressure gradient (MPG) was 14.7 ± 5.1 mm Hg; in Starr-Edwards valve the PPG was 32.8 ±9.1 mm Hg and the MPG was 19.5 ±5.6 mm Hg; in the Carpentier-Edwards valve the PPG was 28.7 ± 10.1 mm Hg and the MPG was 16.1 ± 5.2 mm Hg when size was not specified. The CarboMedics valves were noted to have a better hemodynamic profile in comparison with Starr-Edwards and Carpentier-Edwards prostheses.