PMID- 12643390
OWN - NLM
STAT- MEDLINE
DCOM- 20030401
LR  - 20190628
IS  - 0003-4975 (Print)
IS  - 0003-4975 (Linking)
VI  - 74
IP  - 6
DP  - 2002 Dec
TI  - Nineteen-millimeter prosthetic aortic valves allow normalization of left 
      ventricular mass in elderly women.
PG  - 2022-5
AB  - BACKGROUND: Implantation of small aortic valve prostheses has been reported to be 
      associated with impaired left ventricular (LV) mass regression and incomplete 
      resolution of symptoms although these data have been generated largely with male 
      patients. Therefore we sought to determine the clinical and hemodynamic outcomes 
      of female patients who received a 19-mm aortic valve. METHODS: Between May 1995 
      and December 2000, 38 female patients (average age 73 years, range 42 to 89) 
      underwent isolated aortic valve replacement (AVR; n = 22) or AVR plus coronary 
      artery bypass graft surgery (CABG; n = 16) with a 19-mm aortic prosthesis. The 
      average New York Heart Association (NYHA) class was 3.08 and of the 26 patients 
      who had angina, 47.2% were in CCS class III or IV. Clinical and echocardiographic 
      follow-up was done an average of 33.4 months (8 to 72) after surgery. RESULTS: 
      Operative mortality was 10.5%. Overall survival at an average of 33 months was 
      71.1%. The average NYHA class was 1.52 +/- 0.34 postoperatively (p < 0.001 versus 
      preoperative) and 95% had no anginal symptoms or were in Canadian Cardiovascular 
      Society class I. The LV mass index showed significant regression (114 +/- 11 g/m2 
      to 89 +/- 9 g/m2, p = 0.001) despite an effective orifice area index (EOAI) of 
      0.64 +/- 0.09 cm2/m2. CONCLUSIONS: Despite a very small EOAI, elderly female 
      patients with 19-mm prosthetic aortic valves can experience a satisfactory 
      improvement in symptoms and normalization of LV mass. This finding suggests that 
      small prosthetic aortic valves continue to have an application in contemporary 
      cardiac surgical practice. The current perception of patient-prosthesis mismatch 
      may need to be reconsidered for select populations.
FAU - Freed, Darren H
AU  - Freed DH
AD  - Section of Cardiac Surgery, University of Manitoba, Winnipeg, Manitoba, Canada.
FAU - Tam, James W
AU  - Tam JW
FAU - Moon, Michael C
AU  - Moon MC
FAU - Harding, Gregory E J
AU  - Harding GE
FAU - Ahmad, Ejaz
AU  - Ahmad E
FAU - Pascoe, Edward A
AU  - Pascoe EA
LA  - eng
PT  - Journal Article
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - *Aortic Valve
MH  - Echocardiography
MH  - Female
MH  - Heart Valve Diseases/surgery
MH  - *Heart Valve Prosthesis
MH  - Hemodynamics
MH  - Humans
MH  - Middle Aged
MH  - Prosthesis Design
EDAT- 2003/03/20 04:00
MHDA- 2003/04/02 05:00
CRDT- 2003/03/20 04:00
PHST- 2003/03/20 04:00 [pubmed]
PHST- 2003/04/02 05:00 [medline]
PHST- 2003/03/20 04:00 [entrez]
AID - S0003-4975(02)04079-1 [pii]
AID - 10.1016/s0003-4975(02)04079-1 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 2002 Dec;74(6):2022-5. doi: 10.1016/s0003-4975(02)04079-1.