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

AbstractBACKGROUND:
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.
AuthorsU Bortolotti, G Scioti, A Milano, M De Carlo, R Codecasa, C Nardi, G Tartarini
JournalThe Annals of thoracic surgery (Ann Thorac Surg) Vol. 69 Issue 1 Pg. 47-50 (Jan 2000) ISSN: 0003-4975 [Print] UNITED STATES
PMID10654484 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
Topics
  • Aged
  • Aged, 80 and over
  • Aortic Valve (ultrasonography)
  • Bioprosthesis
  • Body Surface Area
  • Cardiac Output (physiology)
  • Echocardiography, Doppler, Color
  • Female
  • Follow-Up Studies
  • Heart Valve Prosthesis
  • Heart Valve Prosthesis Implantation
  • Heart Ventricles (ultrasonography)
  • Hemodynamics
  • Humans
  • Hypertrophy, Left Ventricular (ultrasonography)
  • Male
  • Postoperative Complications
  • Prosthesis Design
  • Surface Properties
  • Survival Rate
  • Treatment Outcome

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