• G Morocutti, S Gelsomino, L Spedicato, R Frassani, G Bernardi, P Da Col, G Paparella, P Fioretti, and U Livi.
• Department of Cardiovascular Sciences, General Hospital S. Maria della Misericordia, Udine, Italy. g_morocutti@libero.it
• Cardiovasc Surg. 2002 Aug 1;10(4):328-32.

BackgroundThe aim of this study was to assess the utility of intraoperative transesophageal echocardiography (TEE) in the evaluation of patients undergoing aortic valve replacement with the CryoLife-O'Brien (CLOB) Stentless Porcine Aortic Bioprosthesis.MethodsBetween May 1994 and March 1995, 26 patients (15 men, mean age 68.4+/-10.78 years) had a CLOB valve in the aortic position. Transprosthetic gradients and valve regurgitation were detected by intraoperative TEE. Prosthetic regurgitation and transvalvular gradients were evaluated at six-month intervals using transthoracic echo-Doppler (TTE).ResultsThe majority of implants resulted in low gradients (83.7%), with only four patients exhibiting a moderate gradient (15.3%). Color flow Doppler imaging showed central aortic regurgitation in only four of 25 patients (trivial, n=4; mild, n=1). There was one paravalvular leak (trivial, n=1). At follow-up examination (mean 37+/-12 months), 24 of 25 patients exhibited low mean gradients (7.25+/-2.81 mmHg). At follow-up one patient who had low velocities in the LVOT at perioperative evaluation exibited a moderate gradient (45 mmHg) with an effective orifice area of 0.8-0.9 cm(2).ConclusionsIntraoperative TEE was effective in assessing prosthetic stentless valve function.

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