Mid-long-term clinical results and hemodynamic evaluation of aortic valve replacement with 17 mm St. Jude medical regent valve

Objective: To investigate the mid-long-term clinical results of aortic valve replacement with 17 mm St. Jude medical regent valve with hemodynamic evaluation including the measurement of effective orifice area, the occurrence of prosthesis-patient mismatch (PPM) and its affect on heart function.

Methods: There were 44 patients accepted aortic valve replacement with 17 mm St. Jude medical regent valve because of small aortic annulus. Before the operation and during the postoperative follow-up, color doppler echocardiography was used to measure the hemodynamic parameters, such as left ventricular mass (LVmass), effective orifice area (EOA) and effective orifice area index (EOAI), etc.

Results: Transthoracic echocardiographic data were obtained from 39 of 44 patients (88.6%) at 12-55 months after surgery. One (2.27%) died of heart failure in 1 year. According to the current standard of PPM (EOAI < or = 0.85 cm2/m2), 33 cases (82.1%) had PPM, 13 cases (30.8%) had severe PPM with an EOAI < or = 0.65 cm2/m2. After the operation, there were significant decreases in LVAo-PG (19 +/- 8) mmHg and left ventricular mass index (LVmass I) (86.6 +/- 23.3) g/m2 (P < 0.05). The assessment for physical capacity according to NYHA classification: 41 patients improved to class II or better and 2 patients improved to class III (P < 0.05).

Conclusions: The patients with small aortic annulus may obtain satisfactory clinical results after AVR with 17 mm St. Jude medical regent valve, PPM seems not affect the mid-long-term results.