Performance of 21-mm size perimount aortic bioprosthesis in the elderly.

Abstract

BACKGROUND:

Aortic valve replacement in elderly patients with a small aortic annulus may pose difficult problems in terms of prosthesis selection. We have evaluated the hemodynamic performance of the 21-mm Carpentier-Edwards Perimount bioprosthesis implanted in elderly patients.

METHODS:

From July 1996 to June 1998, 19 patients (17 women and 2 men, mean age 76+/-4 years and mean body surface area 1.73+/-0.13 m2), had aortic valve replacement with a 21-mm Carpentier-Edwards Perimount bioprosthesis. The hemodynamic performance of the valve was evaluated in 16 patients, who completed at least a 6-month follow-up interval, with transthoracic color-Doppler echocardiography with particular reference to peak and mean transprosthetic gradients, effective orifice area index, and regression of left ventricular mass index.

RESULTS:

There were no late deaths and no major postoperative complications. At a mean follow-up of 12+/-7 months, compared to discharge, all patients showed clinical improvement with a significant reduction of peak gradient (from 23+/-4 to 21+/-6 mm Hg, p = 0.04) and left ventricular mass index (from 181+/-23 to 153+/-20 g/m2; p<0.001), whereas mean gradient (from 13+/-3 to 13+/-4 mm Hg, p = not significant) and effective orifice area index (from 1.12+/-0.34 to 1.13+/-0.28 cm2/m2, p = not significant) remained substantially unchanged.

CONCLUSIONS:

The use of a 21-mm Carpentier-Edwards Perimount bioprosthesis is associated with low transprosthetic gradients and significant reduction in left ventricular hypertrophy after aortic valve replacement. The results of our study suggest that a 21-m Carpentier-Edwards Perimount bioprosthesis should be considered a valid option in elderly patients with aortic valve disease and a small aortic annulus.

• Authors: U Bortolotti, G Scioti, A Milano, M De Carlo, R Codecasa, C Nardi, G Tartarini
• Journal: The Annals of thoracic surgery (Ann Thorac Surg) Vol. 69 Issue 1 Pg. 47-50 (Jan 2000) ISSN: 0003-4975 [Print] Netherlands
• PMID: 10654484 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Aged
• Aged, 80 and over
• Aortic Valve (diagnostic imaging)
• Bioprosthesis
• Body Surface Area
• Cardiac Output (physiology)
• Echocardiography, Doppler, Color
• Female
• Follow-Up Studies
• Heart Valve Prosthesis
• Heart Valve Prosthesis Implantation
• Heart Ventricles (diagnostic imaging)
• Hemodynamics
• Humans
• Hypertrophy, Left Ventricular (diagnostic imaging)
• Male
• Postoperative Complications
• Prosthesis Design
• Surface Properties
• Survival Rate
• Treatment Outcome