Background And Aim Of The Study: The study aim was to evaluate left ventricular mass (LVM) regression, survival and quality of life in elderly patients after aortic valve replacement (AVR) with small-sized bileaflet prostheses.
Methods: Between September 1988 and September 2005, a total of 147 patients aged > 70 years underwent AVR with 19-mm bileaflet prostheses for aortic stenosis. In order to evaluate the impact of prosthesis-patient mismatch (PPM) on long-term outcome, survivors were allocated to two groups according to the effective orifice area index (EOAI): group A, with EOAI < 0.85 cm2/m2, and group B with EOAI > or = 0.85 cm2/m2. Hospital survivors were interviewed using the SF-36 questionnaire, and the scores compared with those of age- and gender-matched members of the general Italian population.
Results: The mean patient age was 74.5 +/- 3.5 years, body surface area (BSA) 1.68 +/- 0.15 m2, and EOAI 0.73 +/- 0.2 cm2/m2. Hospital mortality was 8.8% (n = 13). Actuarial survival was 87.1 +/- 0.028% at one year, 81.3 +/- 0.035% at five years, and 77.2 +/- 0.044% at eight years. Eight-year survival was 74.0 +/- 0.062% in group A and 82.5 +/- 0.064% in group B (p = 0.29). Echocardiographic follow up showed a significant regression of LVM. Scores obtained in the SF-36 test were similar in the two groups, and significantly higher than those of the general Italian population matched for age and gender (p < 0.001 in all domains).
Conclusion: The implantation of 19-mm bileaflet mechanical prostheses in the elderly allowed LVM regression and a good perceived quality of life. PPM did not influence the long-term survival of these patients.
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JTCVS Tech
December 2024
First Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Objective: In the loop technique for mitral valve repair, the loop bundles are usually created during cardiac arrest after chordal length measurements, which seems time-consuming and less reproducible. To address this issue, we determined the loop length preoperatively using 4-dimensional computed tomography.
Methods: The loop length was determined on the basis of the distance from the papillary muscle head to the free margin of nonprolapsing leaflet corresponding to the prolapsed leaflet, to which the loops would be secured.
Indian J Thorac Cardiovasc Surg
May 2023
#258/A, Bommasandra Industrial Area, Anekal Taluk, Bangalore, 560099 Karnataka India Department of Cardiothoracic Surgery, Narayana Institute of Cardiac Sciences, Narayana Health.
Background: Patient prosthetic mismatch is a serious but avoidable complication of surgical aortic valve replacement (SAVR) complicated by a small aortic annulus. This study aims to compare early and midterm outcomes following aortic valve replacement (AVR) with a mono-leaflet (ML) valve and a bi-leaflet (BL) valve in a small aortic root.
Methods And Selection: From January 1st, 2017 to December 31st, 2019, 98 patients diagnosed with small aortic root underwent isolated aortic valve replacement with either TTK Chitra valve (Mono-leaflet/ ML group) or St.
Gen Thorac Cardiovasc Surg
June 2020
Department of Cardiovascular Surgery, Fukuoka Children's Hospital, 5-1-1 Kashiiteriha, Higashi-ku, Fukuoka, 813-0017, Japan.
Objectives: We examined the outcomes following mitral valve replacement with bileaflet mechanical prosthetic valve in children and identified the predictors for mortality and reoperation.
Methods: Medical records from 49 children who underwent mitral valve replacement between 1982 and 2015 were reviewed retrospectively. Median age and body weight at initial mitral valve replacement were 2.
J Thromb Thrombolysis
July 2014
Duke University Medical Center, 2301 Erwin Road Room 7411A, Durham, NC, 27710, USA,
A 75-year old woman with a history of coronary disease status post 3-vessel coronary artery bypass grafting (CABG) 8 years ago and a repeat one-vessel CABG 2 years ago in the setting of aortic valve replacement with a #19 mm St. Jude bileaflet mechanical valve for severe aortic stenosis presented with two to three weeks of progressive dyspnea and increasing substernal chest discomfort. Echocardiography revealed a gradient to 31 mmHg across her aortic valve, increased from a baseline of 13 mmHg five months previously.
View Article and Find Full Text PDFJ Cardiothorac Surg
September 2012
Department of Cardiac Surgery, Zhongshan Hospital Fudan University & Shanghai Institute of Cardiovascular Diseases, Shanghai, 200032, People's Republic of China.
Background: Aortic valve replacement (AVR) with a small aortic annulus is always challenging for the cardiac surgeon. In this study, we sought to evaluate the midterm performance of implantation with a 17-mm or 19-mm St. Jude Medical Regent (SJM Regent) mechanical valve in retrospective consecutive cohort of patients with small aortic annulus (diameter ≤ 19 mm).
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