| Nineteen-millimeter prosthetic aortic valves allow normalization of left ventricular mass in elderly women. | |
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MedLine Citation:
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PMID: 12643390 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Implantation of small aortic valve prostheses has been reported to be associated with impaired left ventricular (LV) mass regression and incomplete resolution of symptoms although these data have been generated largely with male patients. Therefore we sought to determine the clinical and hemodynamic outcomes of female patients who received a 19-mm aortic valve. METHODS: Between May 1995 and December 2000, 38 female patients (average age 73 years, range 42 to 89) underwent isolated aortic valve replacement (AVR; n = 22) or AVR plus coronary artery bypass graft surgery (CABG; n = 16) with a 19-mm aortic prosthesis. The average New York Heart Association (NYHA) class was 3.08 and of the 26 patients who had angina, 47.2% were in CCS class III or IV. Clinical and echocardiographic follow-up was done an average of 33.4 months (8 to 72) after surgery. RESULTS: Operative mortality was 10.5%. Overall survival at an average of 33 months was 71.1%. The average NYHA class was 1.52 +/- 0.34 postoperatively (p < 0.001 versus preoperative) and 95% had no anginal symptoms or were in Canadian Cardiovascular Society class I. The LV mass index showed significant regression (114 +/- 11 g/m2 to 89 +/- 9 g/m2, p = 0.001) despite an effective orifice area index (EOAI) of 0.64 +/- 0.09 cm2/m2. CONCLUSIONS: Despite a very small EOAI, elderly female patients with 19-mm prosthetic aortic valves can experience a satisfactory improvement in symptoms and normalization of LV mass. This finding suggests that small prosthetic aortic valves continue to have an application in contemporary cardiac surgical practice. The current perception of patient-prosthesis mismatch may need to be reconsidered for select populations. |
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Authors:
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Darren H Freed; James W Tam; Michael C Moon; Gregory E J Harding; Ejaz Ahmad; Edward A Pascoe |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 74 ISSN: 0003-4975 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 2002 Dec |
Date Detail:
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Created Date: 2003-03-19 Completed Date: 2003-04-01 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: United States |
Other Details:
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Languages: eng Pagination: 2022-5 Citation Subset: AIM; IM |
Affiliation:
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Section of Cardiac Surgery, University of Manitoba, Winnipeg, Manitoba, Canada. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Aortic Valve* Echocardiography Female Heart Valve Diseases / surgery Heart Valve Prosthesis* Hemodynamics Humans Middle Aged Prosthesis Design |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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