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DOI: 10.1055/s-0036-1571737
Early Postoperative Results of the Dokimos Plus Stented Pericardial Aortic Bioprosthesis for Isolated Aortic Valve Replacement and Hemodynamic Comparison with Sorin Solo, Labcor TLBP-A, and ATS 3f
Objectives: Evaluation of the early postoperative results after isolated aortic valve replacement with a new stented bioprosthesis, the Dokimos plus, and hemodynamic comparison with other stented and stentless bioprostheses for the aortic position
Methods: The first 50 consecutive patients with a mean age of 64.0 ± 10.7 (range 41–80) years and a mean EuroSCORE II of 2.0 ± 1.7 (range: 0.7–8.2) who underwent an elective isolated aortic valve replacement with the new Dokimos plus mainly for aortic stenosis were reported. Early postoperative clinical data were collected. Hemodynamics of the Dokimos plus obtained with transthoracic echocardiography at discharge were compared with other bioprostheses, namely the Sorin Solo (stentless bovine pericardial), the Labcor TLBP-A (stented porcine) and the ATS 3f (stentless equine pericardial). Study patients were matched for age, aortic valve pathology, size of prostheses, LVEF, weight, height, and mitral regurgitation.
Results: The majority of the operations was performed minimal invasively. Mean size of the implanted Dokimos plus was 25.3 ± 1.8 mm (median: 25; range: 21–27). No intraoperative complications occurred. Mean cross clamp time was 75.8 ± 17.5 minutes. Patients were extubated after a mean of 6.4 ± 5.0 hours. There were no perioperative strokes. Patients were discharged after a mean of 9.8 ± 5.4 days. 30-day mortality was 0%. At discharge no structural or nonstructural valve dysfunctions particularly no relevant regurgitation of the implanted Dokimos plus prostheses was present. Maximum and mean prosthetic pressure gradients were 18.2 ± 7.0 and 9.7 ± 3.9 mm Hg. Comparison with Sorin Solo (Δp mean 10.4 ± 6.6 mm Hg) showed no significant differences of the pressure gradients. However, comparison with the Labcor TLBP-A (Δp mean: 14.1 ± 6.6 mm Hg) and 3f (Δp mean 15.8 ± 4.9 mm Hg) revealed significant lower mean pressure gradients.
Conclusion: The Dokimos is easy to implant and showed perioperatively no peculiarities. Transvalvular pressure gradients are low, comparable to the Sorin Solo and better than those of the Labcor TLBP-A and ATS 3f valves.