Long-term follow-up of small (size 20 and 21) Medtronic-Hall aortic valve prostheses.
BACKGROUND
Our goal was to study the long-term follow-up of patients having aortic valve replacement and to focus particularly on the patients receiving small prostheses.


METHODS
Four hundred twenty-eight Medtronic-Hall valves were implanted (156 size 20 or 21 mm, 149 size 22 or 23 mm, and 123 size 25 or 27 mm). Group 20-21 had a higher number of female patients, more associated coronary lesions, and more patients with aortic stenosis.


RESULTS
The actuarial survival rate at 8 years was 80% for group 20-21, 80% for group 22-23, and 76% for group 25-27 (p = not significant). In group 20-21, the actuarial event-free rates at 8 years were as follows: thromboembolic complications, 94%; prosthetic valve endocarditis, 99%; reoperation, 98%; and hemorrhagic complications, 78%. The only factors of prognostic value in this group were age and associated coronary lesions.


CONCLUSIONS
The durable nature of the results obtained with the Medtronic-Hall 20- and 21-mm prostheses compared with large-diameter prostheses allows the use of a simple and reliable surgical technique and should mean that indications for ring enlargement become rare.
Obadia
J F
JF
Hôpital Cardiologique Louis Pradel, Lyon, France.
Martelloni
Y A
YA
Bastien
O H
OH
Durand de Gevigney
G M
GM
Chassignolle
J F
JF
D001021:Aortic Valve; D001830:Body Surface Area; D018572:Disease-Free Survival; D004696:Endocarditis / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D011474:Prosthesis Design; D012086:Reoperation; D012737:Sex Factors; D015996:Survival Rate; D013923:Thromboembolism / Q000209:etiology