Preliminary experience with the St. Jude Medical Regent mechanical heart valve in the aortic position: early in vivo hemodynamic results.
BACKGROUND
The St. Jude Medical Regent is a new generation mechanical aortic valve.


METHODS
Between March 2000 and July 2001, this valve was implanted in the aortic position in 40 patients (21 men; mean age 59.1 +/- 9.0 years). Preoperatively, 24 patients (60%) were in New York Heart Association functional class III or IV. Eighteen patients (45%) underwent associated procedures. Mean valve size was 21.4 +/- 2.4 mm. The mean duration of follow-up was 8.5 +/- 4.5 months (range, 1 to 16 months).


RESULTS
There were no operative deaths. Early complications included one reoperation for bleeding and one transient low output syndrome. Valve replacement was followed by a significant reduction in mean and peak transaortic gradients over time (p < 0.001) and analysis of variance failed to demonstrate statistical differences between valve size over time (p = not significant). A significant reduction in left ventricular hypertrophy occurred over time (p = 0.01) in all valve sizes (p = not significant between groups): baseline left ventricular mass index was 194 g/cm2; it reduced by 22 g/cm2 (p = 0.006) at discharge. Left ventricular mass index decreased from 172 +/- 55 g/cm2 to 156 +/- 44 g/cm2 (p = 0.03) from discharge to 2 months. Further reductions were not significant. Relative wall thickness decreased from 0.57 +/- 0.13 preoperatively to 0.42 +/- 0.06 at discharge (p = 0.001), and again at 2 months (-0.2; p = not significant), and at 1 year (-0.02; p = not significant).


CONCLUSIONS
The early experience with the St. Jude Medical Regent valve has been satisfactory.
Gelsomino
Sandro
S
Department of Cardiovascular Sciences, General Hospital S. Maria Della Misericordia, Udine, Italy. sandrogelsomino@virgilio.it
Morocutti
Giorgio
G
Da Col
Paolo
P
Frassani
Romeo
R
Carella
Rocco
R
Minen
Giorgio
G
Livi
Ugolino
U
D000328:Adult; D000368:Aged; D001021:Aortic Valve; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology; D011474:Prosthesis Design; D014463:Ultrasonography