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Journal of Cardiothoracic Surgery

Open Access

Prediction of the Transprosthetic Velocity Following Aortic Valve Replacement with Bioprosthesis in the Patients with Aortic Stenosis

  • Yukio Umeda1,
  • Yasunari Yokota2,
  • Yoshio Mori1,
  • Yoko Kawamura3 and
  • Hiroshi Takiya1
Journal of Cardiothoracic Surgery201510(Suppl 1):A246

Published: 16 December 2015


In aortic valve replacement(AVR), to obtain the largest possible effective orifice area index (EOAI) is considered to be desirable to avoid prosthesis patient mismatch in patients with aortic stenosis (AS). In spite of the adequate EOAI, sustained high transprosthetic velocity was often observed in early after AVR with bioprosthesis.


We hypothesized that we could predict the transprosthetic velocity following AVR by clarifying the effect of AVR on cardiac function and peripheral vascular distensibility.


Twenty patients with AS without aortic insufficiency underwent AVR using bioprostheses were recruited. Pre- and post-AVR cardiac function parameters and aortic valve parameters were collected by transthoracic echocardiography. To evaluate the influences of peripheral vascular resistance on transvalvular flow velocity, static distensibility parameters of the carotid artery, such as β stiffness index, pressure-strain elastic modulus (Ep), and arterial compliance (AC), were obtained by a real time echo-tracking system at pre-AVR and 1 week after AVR.


Calculated effective orifice area index (EOAI) of the prosthetic valve was 1.13 ± 0.18. Pre-AVR peak AoV and post-AVR peak transprosthetic velocity was 5.15 ± 0.82 m/s and 2.78 ± 0.59 m/s, respectively. There was significant reduction in peak AoV following AVR. With regards to peripheral vascular resistance, static distensibility parameters of the carotid artery were not affected by AVR (pre- vs post-AVR; β stiffness index, 15.26 ± 6.61 vs 15.07 ± 7.74, Ep, 190.46 ± 83.70 kPa vs 194.69 ± 104.15 kPa, AC, 0.66 ± 0.32 mm2/kPa vs 0.67 ± 0.31 mm2/kPa). No significant changes in LVEF and FS were also found. There was significant correlation between the ratio of peak transprosthetic velocity to pre-AVR peak AoV and the ratio of calculated EOAI to pre-AVR AVAI. As a result, predicted transprosthetic peak velocity could be calculated as (0.7642-0.084 × EOAI /pre-AVR AVAI) × pre-AVR peak AoV.


We explored the effects of AVR on cardiac function and peripheral vascular distensibility. And we found a formula to predict the transprosthetic velocity following AVR.

Authors’ Affiliations

Department of Cardiovascular Surgery, Gifu Prefectural General Medical Center, Gifu City, Japan
Faculty of Engineering, Gifu University, Gifu City, Japan
Research and Development Center for Human Medical Engineering, Gifu University, Gifu City, Japan


© Umeda et al. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.