title: Aortic valve replacement with a 17-mm mechanical prosthesis in octogenarian or older patients.
abstract: OBJECTIVE
  Few studies have reported on aortic valve replacement (AVR) in patients aged >80 years who have small aortic annuli. Various surgical techniques have been proposed for treating such patients. We investigated AVR using small-diameter mechanical valves, in patients aged >80 years, to determine its effectiveness.
  
  
  METHODS
  Eighteen consecutive patients (15 women; 3 men) aged >80 (mean: 83.3 ± 2.7) years underwent surgical AVR with a 17-mm prosthesis. The clinical status and results of pre- and post-operative echocardiography were evaluated. Midterm examination was conducted at 12.0 ± 1.0 months after AVR.
  
  
  RESULTS
  The average preoperative body surface area of the patients was 1.39 ± 0.15 m(2); the average New York Heart Association functional class was 3.28 ± 0.75. Echocardiography showed a peak pressure gradient of 99.1 ± 38.4 mm Hg. Operative mortality was absent. A significant decrease in the peak pressure gradient was found on early (22.6 ± 7.2 mm Hg) and midterm (22.2 ± 8.0 mm Hg) postoperative echocardiography, compared with that in the preoperative period. During this follow-up, 16 patients improved to class I, a significant change in each perioperative period compared with the preoperative period. No mortality was observed at 1 year postoperatively.
  
  
  CONCLUSIONS
  In patients aged >80 years who have small aortic annuli, AVR using a 17-mm prosthesis showed satisfactory clinical and hemodynamic results and provided a satisfactory remote prognosis.
authors.affiliation: Department of Cardiovascular Surgery, Kishiwada City Hospital, Kishiwada-shi, Osaka, Japan. Electronic address: tatsuyaogawa99@hotmail.com.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Ogawa
authors.affiliation: Department of Cardiovascular Surgery, Kishiwada City Hospital, Kishiwada-shi, Osaka, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Onoe
authors.affiliation: Department of Cardiovascular Surgery, Kishiwada City Hospital, Kishiwada-shi, Osaka, Japan.
authors.forename: Souji
authors.initials: S
authors.lastname: Moriwaki
authors.affiliation: Department of Cardiovascular Medicine, Kishiwada City Hospital, Kishiwada-shi, Osaka, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Shioji
authors.affiliation: Department of Cardiovascular Medicine, Kishiwada City Hospital, Kishiwada-shi, Osaka, Japan.
authors.forename: Ayumi
authors.initials: A
authors.lastname: Iwamuro
authors.affiliation: Department of Cardiovascular Medicine, Kishiwada City Hospital, Kishiwada-shi, Osaka, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Uegaito
authors.affiliation: Department of Cardiovascular Medicine, Kishiwada City Hospital, Kishiwada-shi, Osaka, Japan.
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Matsuda
mesh_terms: D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D012189:Retrospective Studies; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods*; D016896:Treatment Outcome
keywords: aortic valve replacement; prosthesis; quality of life