Abstract
Between 1990 and 1996 25 patients with a narrow aortic annulus who underwent aortic valve replacement with mechanical prosthetic valves, sized under 21mm were studied. There were 10 of 19mm Omnicarbon, 10 of 20mm Medtronic Hall and 5 of 19mm St. Jude Medical valves. There were 4 males and 21 females with a mean age of 61±9 years. Their mean body surface area (BSA) was 1.39±0.12m2 There was no operative death or hospital death. Peak pressure gradient across the prosthetic valve (PG) evaluated by post operative (one year or more) doppler echocardiography was 33.3±16.8mmHg. There was no significant difference between the FG and the BSA. However, 6 out of 7 patients with over 4CmmHg of FG had a BSA of over 1.4m2. The LVDd/Ds and LVmass index were significantly lower in the late postoperative period as compared with that of before surgery (50.7/32.6→44.1/25.6mm, 256.1±92→l71.5±54.8g/m2). Best operative NYHA was I in 21 and II in 4 patients. NYHA improved in all patients at the end of the follow up period. In conclusion, less than 21mm aortic prosthetic valve provided satisfactory performance and acceptable in the size for elder patients with a BSA of less than 1.4m2.
