Comparative Study Of Early Clinical Effects Of The PERIMOUNT Valve And The MOSAIC Valve In Valve Replacement

Objective:To compare the short term clinical results after mitral and aortic valve replacement with the Perimount bovine pericardial valve and the MOSAIC valve, provide reference to evaluate what kind of valve is better.Methods:80 patients underwent mitral valve replacement,(50 patients used Perimount bovine pericardial valve, 30 patients used the MOSAIC valve) and 65 patients underwent aortic valve replacement(40 patients used Perimount bovine pericardial valve, 25 patients used the MOSAIC valve) in hospital respectively. Record respectively in patients with preoperative and perioperative data, nosocomial complications, complications within 1 year, 1 year survival rate in general situation, etc.Respectively in the preoperative and postoperative 1 week, 3 months, 1 year line of echocardiography, compare different time points in patients with left atrial diameter(LAD), left ventricular end-diastolic diameter(LVDD), left ventricular end systolic diameter(LVSD), left ventricular ejection fraction(LVEF) and pulmonary artery pressure(PAP);Record postoperative 1 year hemodynamic indexes, including the largest cross valve differential pressure(PG), average across valve differential pressure(MG), across the largest velocity(PV) and the effective orifice area(EOA).Results:Mitral valve replacement:PERIMOUNT valve and MOSAIC two groups of preoperative, perioperative data, nosocomial complications, complications and 1 year survival rate had no statistical significance.Group comparison: PERIMOUNT mitral valve replacement group, postoperative 1 week, 3 months and 1 year of LAD, LVDD and PAP all showed a trend of rise and fall after fall first, but after 1 year LAD, LVDD and PAP is still lower than the preoperative(P < 0.05); LVEF was smaller in postoperative 1 week than the other time. MOSAIC mitral valve replacement group, compared with the preoperative and postoperative 1 week, 3 months and 1 year of LAD, LVDD and PAP all showed a trend of rise and fall after fall first, LAD, LVDD and PAP is still less than 1 year after preoperative(P < 0.05); LVEF was smaller in postoperative 1 week than the other time. Comparison between groups: PERIMOUNT mitral valve replacement with MOSAIC mitral valve replacement group respectively in the preoperative and postoperative 1 week, 3 months and 1 year, LAD, LVDD, LVSD, LVEF and differences of PAP had no statistical significance(P > 0.05).For different valve size 27, 29, PERIMOUNT group has lower PG, MG and PV than the MOSAIC disc group, the difference had statistical significance.Aortic valve replacement: PERIMOUNT valve and the MOSAIC valve groups of preoperative, perioperative data, nosocomial complications, complications and 1 year survival rate had no statistical significance.Group comparison: PERIMOUNT aortic valve replacement group, postoperative 1 week, 3 months and 1 year of LAD, LVDD and PAP all rise and fall after first fall, but the LAD, LVDD and PAP is still less than 1 year after preoperative(P < 0.05); LVEF was smaller in postoperative 1 week than the other time. MOSAIC aortic valve replacement group, postoperative 1 week, 3 months and 1 year of LAD, LVDD and PAP all showed a trend of rise and fall after fall first, but after 1 year LAD, LVDD and PAP is still lower than the preoperative(P < 0.05); LVEF was smaller in postoperative 1 week than the other time. Comparison between groups: PERIMOUNT aortic valve replacement with MOSAIC aortic valve replacement group respectively in the preoperative and postoperative 1 week, 3 months and 1 year, LAD, LVDD, LVSD, LVEF and differences of PAP had no statistical significance(P > 0.05).For different valve size, PERIMOUNT group has lower PG, MG and PV than the MOSAIC group, a larger EOA are perfectly legal(P < 0.05), the difference had statistical significance.Conclusion:1. PERIMOUNT and MOSAIC group in postoperative 1 week, 3 months and 1 year are significantly improved in cardiac function and left ventricular restoration, there are no difference between the two group.2. For PERIMOUNT in postoperative 1 year, hemodynamic is better than MOSAIC group, with a lower PG, MG, PV, for the mitral valve replacement,there is no difference in EOA,for the aortic valve replacement, PERIMOUNT has a larger EOA.