ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Ann Thorac Surg 2009;87:90-94. doi:10.1016/j.athoracsur.2008.09.051
© 2009 The Society of Thoracic Surgeons
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Takashi Ino
Hideo Adachi
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Okamura, H.
Right arrow Articles by Adachi, H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Okamura, H.
Right arrow Articles by Adachi, H.
Related Collections
Right arrow Valve disease

Original Articles: Adult Cardiac

The 17-mm St. Jude Medical Regent Valve Is a Valid Option for Patients With a Small Aortic Annulus

Homare Okamura, MD*, Atsushi Yamaguchi, MD, Masashi Tanaka, MD, Kazuhiro Naito, MD, Naoyuki Kimura, MD, Chieri Kimura, MD, Toshiyuki Kobinata, MD, Takashi Ino, MD, Hideo Adachi, MD

Department of Cardiovascular Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan

Accepted for publication September 23, 2008.

* Address correspondence to Dr Okamura, Department of Cardiovascular Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho Omiya-ku Saitama-shi, Saitama, 330-8503, Japan (Email: homareokamura{at}hotmail.co.jp).

Background: When aortic valve replacement is performed in patients with a small aortic annulus, prosthesis–patient mismatch is of concern. Such prosthesis–patient mismatch may affect postoperative clinical status and survival. We investigated the outcomes of isolated aortic valve replacement performed with a 17-mm mechanical prosthesis in patients with aortic stenosis.

Methods: Twenty-three patients with aortic stenosis (mean age, 74.6 ± 6.3 years) underwent isolated aortic valve replacement with a 17-mm St. Jude Medical Regent prosthesis. Mean body surface area was 1.41 ± 0.13 m2. Preoperative echocardiography yielded a mean aortic valve area of 0.36 ± 0.10 cm2/m2, a mean left ventricular–aortic pressure gradient of 68.4 ± 25.3 mm Hg, and a mean left ventricular mass index of 200 ± 69 g/m2.

Results: There was no operative mortality, and there were no valve-related events. Echocardiography at 14.0 ± 10.0 months after aortic valve replacement showed a significant increase in the mean effective orifice area index (0.95 ± 0.24 cm2/m2), decrease in the mean left ventricular–aortic pressure gradient (17.4 ± 8.2 mm Hg), and decrease in the mean left ventricular mass index (124 ± 37 cm2/m2). Prosthesis–patient mismatch (effective orifice area index < 0.85 cm2/m2) was present in 8 patients at discharge. In these patients as well as in those without prosthesis–patient mismatch, the left ventricular mass index decreased remarkably during follow-up.

Conclusions: Aortic valve replacement with a 17-mm Regent prosthesis appears to provide satisfactory clinical and hemodynamic results in patients with a small aortic annulus. Remarkable left ventricular mass regression during follow-up was achieved irrespective of the effective orifice area index at discharge.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2009 by The Society of Thoracic Surgeons.