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Hemodynamic assessment of the Ionescu-Shiley pericardial xenograft in the mitral position.

While the very low thrombogenicity without anticoagulant therapy and generally good durability of the lonescu-Shiley bioprosthesis has been demonstrated, further hemodynamic assessment is necessary. The present study assessed cardiac function and heterograft performance during right and left heart catheterization at rest and exercise (three to six months postoperation) of eight patients with severe mitral stenosis and/or regurgitation prior to surgery. We found, comparing pre- and postoperative resting values, that mean pulmonary artery pressure decreased (32 +/- 2.7 to 22 +/- 3.5 mm Hg; P < 0.02), cardiac index increased (2.1 +/- 0.09 to 2.5 +/- 0.13 liters/min/m2; P < 0.01), pulmonary wedge pressure decreased (21 +/- 2.3 to 13 +/- 1.8 mm Hg; P < 0.01), and the clinical status (NYHA) improved markedly. Mean diastolic gradient across the pericardial xenograft was 6.1 +/- 1.1 mm Hg at rest and 14.6 +/- 2.3 mm Hg on exercise. The calculated xenograft surface area was 1.7 cm2 at rest and 2.0 cm2 during exercise. No regurgitation was detected in seven of eight patients. Thus, mitral lonescu-Shiley bioprosthesis provide excellent heterograft function.