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Ann Thorac Surg 2007;83:2050-2053
© 2007 The Society of Thoracic Surgeons

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Original Articles: Cardiovascular

Aortic Valve Replacement With 17-mm St. Jude Medical Prostheses for a Small Aortic Root in Elderly Patients

Department of Cardiovascular Surgery, Clinical Research Institute, National Hospital Organization, Kyusyu Medical Center, Fukuoka, Japan

Accepted for publication January 22, 2007.

^_* Address correspondence to Dr Kawara, Department of Cardiovascular Surgery, National Hospital Organization, Kyusyu Medical Center, 1-8-1 Chuo-ku Chigyohama, Fukuoka, 810-8563, Japan (Email: kawara{at}kyumed.jp).

Background: There are few reports about the optimal prosthesis for elderly patients who have small aortic roots with an aortic annular size of less than 19 mm.

Methods: From October 2004 to October 2006, 11 women aged 70 years or older (mean age, 74.9 ± 3.5 years) underwent aortic valve replacement with a 17-mm Regent prosthesis (St. Jude Medical, St. Paul, MN), with the size determined using the manufacturer’s sizer. Clinical status and the results of preoperative and postoperative echocardiography were evaluated.

Results: The patients had a mean body surface area of 1.33 ± 0.13 m². Preoperative average New York Heart Association (NYHA) functional class was 2.5 ± 0.7. Preoperative echocardiography showed a mean indexed effective orifice area of 0.33 ± 0.14 cm²/m² and a left ventricular mass index of 175 ± 63 g/m². Seven patients underwent associated procedures. Postoperative ventilation time was 14 ± 5.6 hours, and the intensive care unit stay was 1.0 ± 0.4 days. No patients died perioperatively. The NYHA functional class improved to class I in 9 patients. No obstruction of valve opening was observed. A significant increase in the mean indexed effective orifice area (0.87 ± 0.10 cm²/m²) and regression of left ventricular mass index were found (114 ± 46 cm²/m²) on postoperative echocardiography.

Conclusions: Aortic valve replacement in elderly patients with small aortic roots (less than 19 mm) using a 17-mm Regent prosthesis showed satisfactory clinical and hemodynamic results.

This article has been cited by other articles:

				H. Okamura, A. Yamaguchi, M. Tanaka, K. Naito, N. Kimura, C. Kimura, T. Kobinata, T. Ino, and H. Adachi The 17-mm St. Jude Medical Regent Valve Is a Valid Option for Patients With a Small Aortic Annulus Ann. Thorac. Surg., January 1, 2009; 87(1): 90 - 94. [Abstract] [Full Text] [PDF]

				S. Collison, Y. Mishra, and Z. S. Meherwal Aortic Valve Replacement With 17-mm Prosthesis: Emerging Evidence of Its Efficacy Ann. Thorac. Surg., February 1, 2008; 85(2): 692 - 693. [Full Text] [PDF]

				T. Takaseya, T. Kawara, S. Suzuki, Y. Oishi, H. Sonoda, and S. Morita Reply Ann. Thorac. Surg., February 1, 2008; 85(2): 693 - 693. [Full Text] [PDF]