Document Detail


Hemodynamics and outcomes of aortic valve replacement with a 17- or 19-mm valve.
MedLine Citation:
PMID:  20947599     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
When aortic valve replacement is performed in patients with a small aortic annulus, prosthesis-patient mismatch is of concern because it may affect postoperative clinical status. We conducted a retrospective study of outcomes in 65 patients with aortic stenosis requiring valve replacement. Fifty were given a 17-mm or 19-mm St. Jude Regent mechanical valve, and 15 were given a 19-mm Medtronic Mosaic bioprosthesis. Echocardiography was carried out preoperatively, at discharge, and at follow-up. There was 1 (2%) operative death in the Regent group and none in the Mosaic group. There was no valve-related event. Follow-up echocardiography in both groups revealed a significant increase in the mean effective orifice area index, a decrease in the mean left ventricular-aortic pressure gradient, and a decrease in the mean left ventricular mass index. Prosthesis-patient mismatch (effective orifice area index <0.85 cm(2) · m(-2)) existed in 13 (26%) patients in the Regent group and 11 (73%) in the Mosaic group at discharge. All patients improved to New York Heart Association functional class II or better. A small-sized prosthesis may provide satisfactory clinical and hemodynamic results in patients with a small aortic annulus.
Authors:
Homare Okamura; Atsushi Yamaguchi; Kenichiro Noguchi; Kazuhiro Naito; Koichi Yuri; Hideo Adachi
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Asian cardiovascular & thoracic annals     Volume:  18     ISSN:  1816-5370     ISO Abbreviation:  Asian Cardiovasc Thorac Ann     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-15     Completed Date:  2011-02-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9503417     Medline TA:  Asian Cardiovasc Thorac Ann     Country:  Singapore    
Other Details:
Languages:  eng     Pagination:  450-5     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Surgery, Saitama Medical Center, Jichi Medical University, Saitama-shi, Saitama, Japan. homareokamura@hotmail.co.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Aortic Valve / physiopathology,  surgery*,  ultrasonography
Aortic Valve Stenosis / mortality,  physiopathology,  surgery*,  ultrasonography
Female
Heart Valve Prosthesis*
Heart Valve Prosthesis Implantation / adverse effects,  instrumentation*,  mortality
Hemodynamics*
Humans
Japan
Male
Middle Aged
Prosthesis Design
Recovery of Function
Retrospective Studies
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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