PMID- 16613153
OWN - NLM
STAT- MEDLINE
DCOM- 20060523
LR  - 20061115
IS  - 0021-5252 (Print)
IS  - 0021-5252 (Linking)
VI  - 59
IP  - 4
DP  - 2006 Apr
TI  - [Aortic valve replacement in elderly patients with small aortic annulus; is the 
      indexed effective orifice area important?].
PG  - 329-35
AB  - We sought to determine whether the small indexed effective orifice area (EOAI) 
      increased mortality and morbidity after aortic valve replacement (AVR) in 
      patients over 75 years of age. From May 1999 to July 2005, 77 patients underwent 
      isolated AVR for aortic stenosis. They were divided into 3 groups (S-EOAI : EOAI 
      < or = 0.7 cm2/m2, M-EOAI : 0.7 cm2/m2 <EOAI < or = 0.85 cm2/ m2, L-EOAI : 
      0.85cm2/m2 <EOAI) for evaluation. We examined the body surface area (BSA), EOAI, 
      and the left ventricular (LV) mass index (LVMI). We found that patients with 
      S-EOAI had less symptomatic improvement (p <0.05, vs L-EOAI) and LV mass 
      regression (p< 0.01, vs L-EOAI). But, their average New York Heart Association 
      (NYHA) class was improved significantly (2.3 +/- 0.8 vs 1.8 +/- 0.7 : 
      preoperative vs postoperative, p=0.001). Furthermore, severe patient-prosthesis 
      mismatch (PPM) had no significant negative impacts on the freedom of 
      valve-related complications (75.1% : S-EOAI group vs 92.0% : L-EOAI group) and 
      the 5-year survival (84.9% : S-EOAI group vs 87.8% : L-EOAI group). In elderly 
      patients, the average NYHA class was 1.9 +/- 0.6 postoperatively (p<0.0001 vs 
      preoperative) and the LVMI showed significant regression (p<0.0001) despite an 
      average EOAI of 0.73 +/- 0.13 cm2/m2. It is important to consider whether the 
      benefits of avoiding PPM overcome the drawbacks of other complicated techniques. 
      In this study, we found that moderate PPM (0.7 cm2/m2 < or = EOAI) is acceptable 
      to elderly patients.
FAU - Baba, H
AU  - Baba H
AD  - Department of Cardiovascular Surgery, Toyohashi Heart Center, Japan.
FAU - Aoki, M
AU  - Aoki M
FAU - Nishimura, Y
AU  - Nishimura Y
FAU - Hashimoto, M
AU  - Hashimoto M
FAU - Okawa, Y
AU  - Okawa Y
LA  - jpn
PT  - English Abstract
PT  - Journal Article
PL  - Japan
TA  - Kyobu Geka
JT  - Kyobu geka. The Japanese journal of thoracic surgery
JID - 0413533
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Valve/*surgery
MH  - Aortic Valve Stenosis/physiopathology/*surgery
MH  - Body Surface Area
MH  - Echocardiography
MH  - Female
MH  - *Heart Valve Prosthesis
MH  - *Heart Valve Prosthesis Implantation
MH  - Humans
MH  - Male
MH  - Prognosis
MH  - Prosthesis Design
MH  - Prosthesis Fitting
MH  - Ventricular Function, Left
EDAT- 2006/04/15 09:00
MHDA- 2006/05/24 09:00
CRDT- 2006/04/15 09:00
PHST- 2006/04/15 09:00 [pubmed]
PHST- 2006/05/24 09:00 [medline]
PHST- 2006/04/15 09:00 [entrez]
PST - ppublish
SO  - Kyobu Geka. 2006 Apr;59(4):329-35.