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

Original Articles: Cardiovascular

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

Tohru Takaseya, MD, PhD, Takemi Kawara, MD, PhD*, Shigehiko Tokunaga, MD, PhD, Michitaka Kohno, MD, Yasuhisa Oishi, MD, PhD, Shigeki Morita, MD, PhD

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:


Home page
 Ann. Thorac. Surg.Home page
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]

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