The effects of 21 and 23 milimeter aortic valve prosthesis on hemodynamic performance and functional capacity in young adults.
OBJECTIVE
Early and medium-term improvement of functional capacity and regression of left ventricular hypertrophy was evaluated in the young adult patient group following application of 21 mm or 23 mm bileaflet aortic mechanical valve prosthesis due to aortic stenosis. Methods : Twenty two patients (10 male, 12 female; mean age 27+-8.2 (19-43)) who underwent isolated aortic valve replacement due to rheumatic aortic stenosis, were included in the study. 21 mm and 23 mm bileaflet mechanical prosthesis was used respectively in eight and fourteen patients. The mean body surface area was 1.86 m(2) and 1.68 m(2) respectively in 23 mm and 21 mm prosthesis while 1.73 ±0.25 m(2) for the whole group. Functional capacity was New York Heart Association (NYHA) class II in 9 patients and class III in thirteen patients. Implantation was performed without enlarging the aortic root in all except four patients. In all patients transvalvular gradients, effective orifice area and the diameter of left ventricle were measured with transthoracic echocardiography during rest and after maximal exercise. Mean follow-up was 34±12 months (range 11-57 months).


RESULTS
There were no postoperative complications or deaths. All the patients were assessed as NYHA class I with regards to functional capacity (p=0.01). Significant improvements were determined in postoperative mean transvalvular gradient (p=0.005) and left ventricular mass index (p=0.01) when compared with preoperative values.


CONCLUSIONS
Our findings show that replacement with 21 mm and 23 mm mechanical prosthesis provides a significant improvement in regression of symptoms and increase of functional capacity in young adults in early and mid-period without increasing mortality and morbidity.
Ali Umit Yener, Department of Cardiovascular Surgery, Canakkale Onsekiz Mart University, Faculty of Medicine, Canakkale, Turkey.
Ali Umit
AU
Yener
Sedat Ozcan, Department of Cardiovascular Surgery, Canakkale Onsekiz Mart University, Faculty of Medicine, Canakkale, Turkey.
Sedat
S
Ozcan
Ali Baran Budak, Department of Cardiovascular Surgery, Canakkale Onsekiz Mart University, Faculty of Medicine, Canakkale, Turkey.
Ali Baran
AB
Budak
Serhat Bahadir Genc, Department of Cardiovascular Surgery, Canakkale Onsekiz Mart University, Faculty of Medicine, Canakkale, Turkey.
Serhat Bahadir
SB
Genc
Turgut Ozkan, Department of Cardiovascular Surgery, Canakkale Onsekiz Mart University, Faculty of Medicine, Canakkale, Turkey.
Turgut
T
Ozkan
Omer Faruk Cicek, Department of Cardiovascular Surgery, Ankara Yuksek Ihtisas Education and Research Hospital, Ankara-Turkey.
Omer Faruk
OF
Cicek
Aortic valve; aortic valve stenosis; echocardiography; transvalvular gradient; valve surgery