title: Mid-term outcomes after aortic valve replacement with the 17-mm St. Jude Medical Regent valve.
abstract: BACKGROUND
  When aortic valve replacement (AVR) is performed in patients with a small aortic annulus, prosthesis-patient mismatch (PPM) is of concern. We investigated the mid-term outcomes of AVR with a 17-mm mechanical prosthesis.
  
  
  RESULTS
  Seventy-eight patients with aortic stenosis underwent AVR with a 17-mm St. Jude Medical Regent prosthesis. Echocardiography was performed preoperatively, at discharge, and at follow-up (mean follow-up, 33 months). Patients were divided into 2 groups: with and without PPM at discharge. Between-group differences in postoperative variables, particularly survival, were analyzed. Overall hospital mortality was 2.6%. Actuarial 1- and 5-year survival rates were 95% and 79%, respectively. Diabetes and renal insufficiency were associated with long-term mortality. Freedom from major adverse valve-related cardiac events at 1 year and 5 years was 97.3% and 93.9%, respectively. Diabetes was shown to be an independent risk factor for major adverse valve-related cardiac events. Echocardiography 13 months after AVR showed a significant increase in mean effective orifice area index, decrease in mean left ventricular-aortic pressure gradient, and decrease in mean left ventricular mass index. PPM at discharge did not influence long-term survival or left ventricular mass regression.
  
  
  CONCLUSIONS
  The 17-mm Regent prosthesis provided satisfactory clinical and hemodynamic results. It is a reliable choice for patients with a small aortic annulus.
authors: Department of Cardiovascular Surgery, Saitama Medical Center, Jichi Medical University, Japan. homareokamura@hotmail.co.jp
authors: Homare
authors: H
authors: Okamura
authors: Atsushi
authors: A
authors: Yamaguchi
authors: Hiroshi
authors: H
authors: Nagano
authors: Satoshi
authors: S
authors: Itoh
authors: Hideki
authors: H
authors: Morita
authors: Kazuhiro
authors: K
authors: Naito
authors: Koichi
authors: K
authors: Yuri
authors: Hideo
authors: H
authors: Adachi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000401:mortality* / Q000601:surgery*; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000401:mortality; D006350:Heart Valve Prosthesis / Q000009:adverse effects / Q000706:statistics & numerical data*; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation* / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D009017:Morbidity; D011183:Postoperative Complications / Q000401:mortality; D016016:Proportional Hazards Models; D016896:Treatment Outcome