Haemodynamic performance of DAH
The mean diameter of implanted DAHs was 22.4 ± 3.7 mm (range, 10–29 mm), the average peak gradient was 14 ± 15 mmHg and the mean aortic regurgitation grade (0.5 = trace and 1 = mild) was 0.6 ± 0.5. The last mean left ventricle ejection fraction (LVEF) and left ventricle end diastolic volume index (LV EDVi) was 63 ± 7% and 78 ± 16 ml/m2 body surface area (BSA), respectively. The mean effective orifice area (EOA) of a 25-mm diameter DAH was 3.07 ± 0.7 cm2.
Figures 1 and 2 show the development of mean gradients and regurgitation in the DAH over time.
Figure 1: Echocardiographic mean gradient over time in the DAH. Different colours represent different patients; loess-smoothed lines are interpolated between the measurements for each individual. Some individuals show gradients that decrease over time.
Figure 2: Valvular regurgitation over time in DAH (0 = none, 0.5 = trace, 1 = mild, 1.5 = mild to moderate, 2 = moderate, 2.5 = moderate to severe and 3 = severe). This figure shows the individual aortic valve insufficiency development and loess-smoothed interpolation lines. The decrease of insufficiency is not uncommon.
Figure 3 summarizes the portion of explanted, well-functioning and dysfunctional grafts (>49 mm Hg peak gradient and/or at least moderate regurgitation) at the various examination intervals. For 3 Moldavian patients, only clinical follow-up was available.
Figure 3: Freedom from explantation including the percentage of conduits with degeneration signs for the DAH (peak gradient >49 mmHg and/or at least moderate regurgitation). For 3 Moldavian patients, only clinical follow-up was available.