PMID- 11834061
OWN - NLM
STAT- MEDLINE
DCOM- 20020222
LR  - 20190628
IS  - 0003-4975 (Print)
IS  - 0003-4975 (Linking)
VI  - 73
IP  - 1
DP  - 2002 Jan
TI  - Clinical outcome in patients with 19-mm and 21-mm St. Jude aortic prostheses: 
      comparison at long-term follow-up.
PG  - 37-43
AB  - BACKGROUND: Small-sized prostheses for aortic valve replacement may result in 
      residual left ventricular outflow tract obstruction. Aim of the study was to 
      verify whether implantation of 19-mm versus 21-mm St. Jude Medical standard 
      prostheses (St. Jude Medical, Inc, St. Paul, MN) influences long-term clinical 
      outcome. METHODS: Two hundred twenty-nine patients who underwent aortic valve 
      replacement with 19 mm (group 1, 53 patients) or 21-mm St. Jude Medical standard 
      prostheses (group 2, 176 patients) were included in the study. Mean follow-up of 
      current survivors was 10+/-4 years. RESULTS: Operative mortality was 7.5% in 
      group 1 and 8.5% in group 2. At discharge, an important patient-prosthesis 
      mismatch (effective orifice area index < or = 0.60 cm2/m2) was present in 18% of 
      group 1 versus 5% in group 2 (p = 0.004). Among patients with body surface area 
      less than 1.70 m2, such mismatch was present in 15% of group 1 versus 2% of group 
      2 (p = 0.008). At last follow-up New York Heart Association (NYHA) functional 
      class (p < 0.001), left ventricular mass reduction (p = 0.02), mean (p = 0.002) 
      and peak transprosthetic gradients (p < 0.001), and effective orifice area index 
      (p = 0.005) were significantly better in group 2. Freedom from sudden death 
      (92%+/-5% vs 99%+/-1%, p = 0.01), valve-related death (84%+/-6% vs 90%+/-5%, p = 
      0.02), and cardiac events (56%+/-13% vs 86%+/-4%, p = 0.008), were significantly 
      lower in group 1. Effective orifice area index was an independent predictor of 
      late cardiac events. CONCLUSIONS: Although long-term results after aortic valve 
      replacement with small-sized St. Jude Medical standard prostheses are 
      satisfactory, 19-mm valve recipients show a high prevalence of important 
      patient-prosthesis mismatch with less evident functional improvement and higher 
      rate of cardiac events, suggesting a very cautious use of this prosthesis.
FAU - Milano, Aldo D
AU  - Milano AD
AD  - Divisions of Cardiac Surgery and Cardiology, Cardio-Thoracic Department 
      University of Pisa Medical School, Italy.
FAU - De Carlo, Marco
AU  - De Carlo M
FAU - Mecozzi, Gianclaudio
AU  - Mecozzi G
FAU - D'Alfonso, Alessandro
AU  - D'Alfonso A
FAU - Scioti, Giovanni
AU  - Scioti G
FAU - Nardi, Carmela
AU  - Nardi C
FAU - Bortolotti, Uberto
AU  - Bortolotti U
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
SB  - IM
MH  - Aged
MH  - Aortic Valve Stenosis/diagnostic imaging/*surgery
MH  - Echocardiography, Doppler
MH  - Female
MH  - Follow-Up Studies
MH  - *Heart Valve Prosthesis
MH  - *Heart Valve Prosthesis Implantation/adverse effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Proportional Hazards Models
MH  - Prosthesis Design
MH  - Treatment Outcome
EDAT- 2002/02/09 10:00
MHDA- 2002/02/23 10:01
CRDT- 2002/02/09 10:00
PHST- 2002/02/09 10:00 [pubmed]
PHST- 2002/02/23 10:01 [medline]
PHST- 2002/02/09 10:00 [entrez]
AID - S0003-4975(01)03306-9 [pii]
AID - 10.1016/s0003-4975(01)03306-9 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 2002 Jan;73(1):37-43. doi: 10.1016/s0003-4975(01)03306-9.