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Ann Thorac Surg 1997;64:421-425
© 1997 The Society of Thoracic Surgeons

Original Articles: Cardiovascular

Long-Term Follow-up of Small (Size 20 and 21) Medtronic-Hall Aortic Valve Prostheses

Jean-Francois Obadia, MD, PhD, Yvan A. Martelloni, MD, Olivier H. Bastien, MD, Guy M. Durand de Gevigney, MD, Jean-Francois Chassignolle, MD

Hôpital Cardiologique Louis Pradel, Lyon, France

Accepted for publication February 7, 1997.

Background. Our goal was to study the long-term follow-up of patients having aortic valve replacement and to focus particularly on the patients receiving small prostheses.

Methods. Four hundred twenty-eight Medtronic-Hall valves were implanted (156 size 20 or 21 mm, 149 size 22 or 23 mm, and 123 size 25 or 27 mm). Group 20–21 had a higher number of female patients, more associated coronary lesions, and more patients with aortic stenosis.

Results. The actuarial survival rate at 8 years was 80% for group 20–21, 80% for group 22–23, and 76% for group 25–27 (p = not significant). In group 20–21, the actuarial event-free rates at 8 years were as follows: thromboembolic complications, 94%; prosthetic valve endocarditis, 99%; reoperation, 98%; and hemorrhagic complications, 78%. The only factors of prognostic value in this group were age and associated coronary lesions.

Conclusions. The durable nature of the results obtained with the Medtronic-Hall 20- and 21-mm prostheses compared with large-diameter prostheses allows the use of a simple and reliable surgical technique and should mean that indications for ring enlargement become rare.




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