Long-term follow up in patients receiving a small aortic valve prosthesis.
OBJECTIVE
Concern persists regarding the long-term effects of aortic valve replacement (AVR) in the small aortic root.


METHODS
Twenty-eight patients (21 females, seven males; mean age 54.1+/-11.7 years; mean body surface area (BSA) 1.39+/-0.07 m2) who underwent AVR with a 19 mm mechanical valve more than 10 years previously at the authors' institute, were followed up. Long-term echocardiographic evaluations were performed in 18 of 21 survivors.


RESULTS
Follow up in the 28 patients was complete for up to 19.2 years (mean 11.4 years); cumulative follow up was 318.1 patient-years. Actuarial survival rates at 5, 10 and 15 years were 88.5+/-6.3%, 72.0+/-9.0% and 72.0+/-9.0%, respectively. In general, NYHA class showed satisfactory improvement. Long-term echocardiography showed significant reductions in left ventricular (LV) wall thickness and mass index compared with preoperative values, despite the existence of pressure gradients. A negative correlation was found between the rate of reduction of LV wall thickness and BSA.


CONCLUSIONS
Implantation of the 19 mm aortic mechanical prosthesis was viable in patients with a small aortic annulus, especially if their BSA was <1.45 m2.
Arata
Ken-Ichi
K
Second Department of Surgery, Faculty of Medicine, Kagoshima University, Sakuragaoka, Japan.
Iguro
Yoshifumi
Y
Masuda
Hiroshi
H
Kinjo
Tamahiro
T
Matsumoto
Hitoshi
H
Yotsumoto
Gouichi
G
Sakata
Ryuzo
R
Taira
Akira
A
D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000401:mortality / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000601:surgery; D001830:Body Surface Area; D018572:Disease-Free Survival; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006346:Heart Septum / Q000000981:diagnostic imaging; D019918:Heart Valve Prosthesis Implantation; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D015203:Reproducibility of Results; D013995:Time; D013997:Time Factors; D016896:Treatment Outcome