title: Mid-term evaluation of Sorin Soprano bioprostheses in patients with a small aortic annulus <or=20 mm.
abstract: We set to examine the mid-term outcome after aortic valve replacement (AVR) with Soprano pericardial stented bioprosthesis measuring <or=20 mm. Sixty-eight patients underwent AVR between June 2003 and January 2006 (50 women; median age 77 years; range 60-89 years). Preoperatively, 60 patients (88.2%) were in New York Heart Association (NYHA) class III/IV. The mean EuroSCORE was 6.7+/-2.3. Supra-annular aortoplasty was performed in 21 patients (30.9%), out of which 11 patients received an 18 mm prosthesis (55%). The median follow-up was 45.5 months (0.1-62 months). The 30-day mortality was 4.4% (n=3) with no early valve-related deaths. No patient suffered a cerebrovascular accident and no patient required replacement of prosthesis for coronary malperfusion. Postoperatively, the mean gradient across the 18 mm bioprosthesis (n=20) was 25+/-8.9 mmHg and across the 20 mm bioprosthesis (n=48) was 25.5+/-7.3 mmHg (P=NS). During follow-up, there was no valve-related death, re-operation for structural valve degeneration, endocarditis or valve thrombosis. There were five late deaths and actuarial survival at three and five years was 92.7+/-3.1% and 81.0+/-6.9%, respectively. At last follow-up, 86.7% (n=52) of survivors were in NYHA class I/II. AVR with Soprano bioprosthesis measuring <or=20 mm is associated with excellent mid-term outcome. Continued follow-up is required to determine the long-term efficacy of the prosthesis.
authors: Wessex Cardiothoracic Centre, Southampton University Hospitals NHS Trust, Southampton, UK.
authors: Hunaid A
authors: HA
authors: Vohra
authors: Robert N
authors: RN
authors: Whistance
authors: Marco
authors: M
authors: Bolgeri
authors: Theodore
authors: T
authors: Velissaris
authors: Geoffrey M K
authors: GM
authors: Tsang
authors: Clifford W
authors: CW
authors: Barlow
authors: Sunil K
authors: SK
authors: Ohri
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D001705:Bioprosthesis; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D006439:Hemodynamics; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D011474:Prosthesis Design; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome