Hemodynamic Function of the Kay-Shiley Prosthetic Cardiac Valve

Observations after Mitral or Tricuspid Valve Replacement

¹ Cardiology Branch and Surgery Branch, National Heart and Lung Institute, Bethesda

Eighteen patients were catheterized before and nine months (average) after mitral and/or tricuspid valve replacement with the Kay-Shiley prosthesis. In 14 patients with Kay-Shiley mitral prostheses, average cardiac index rose from 2.2 L/min/M² preoperatively to 2.8 postoperation, average left atrial mean pressure fell from 26 to 18 mm Hg, and the average left atrioventricular mean diastolic gradient decreased from 15 to 8 mm Hg. In eight patients with Kay-Shiley tricuspid prostheses, average cardiac index rose from 1.74 to 2.54 L/min/M², average right atrial mean pressure fell from 13 to 10 mmHg, and the average mean diastolic gradient across the tricuspid prostheses was 4 mmHg. The in vivo effective orifice areas of the Kay-Shiley mitral and tricuspid prostheses averaged 75 percent of the in vitro orifice areas. Kay-Shiley mitral prostheses were used only when the left ventricle was too small to accommodate a Starr-Edwards prosthesis; consequently, the Kay-Shiley protheses employed were small, accounting in part for significant prosthetic stenosis observed in some patients.