[Impacts of aortic valve replacement on cardiac function in patients with aortic stenosis].

To prevent patient-prosthesis mismatch (PPM) after aortic valve replacement (AVR), we set up our original standard criteria for the selection of the size of the prosthetic valve. We also routinely perform supra-annular enlargement in patients with small aortic annuli. The objective of this study was to assess the impact of our procedure on the postoperative cardiac function of patients suffering from aortic stenosis (AS). We retrospectively reviewed 102 consecutive surgical patients with AS from 1999 to 2004. The patients were classified into the following 3 groups based on the sizes of their prosthesis (group S : 19 mm prosthesis, n = 34; group M : 21 mm prosthesis, n = 51; and group L : > 23 mm prosthesis, n = 17). Cardiac function was evaluated using echocardiography preoperatively, immediately postoperatively, and 6 months after the operation. There were no hospital deaths during the study period. A favorable hemodynamic outcome of all 3 groups was achieved. Our surgical strategy for AS was thought to be useful to prevent PPM after AVR.