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THE JOURNAL OF CARDIOVASCULAR SURGERY
Rivista di Chirurgia Cardiaca, Vascolare e Toracica
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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ORIGINAL ARTICLES CARDIAC PAPERS
The Journal of Cardiovascular Surgery 2000 Febbraio;41(1):31-6
Comparison of 21-23 size St. Jude medical valves to the 27-29 size mechanical valves in aortic position. Ten-year follow-up
Katircioglu S. F., Yamak B., Ulus A. T., Yildiz Ü., Mavitas¸ B., Birincioglu C. L., Tasdemir O.
From the Department of Cardiovascular Surgery Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey
Background. Between 1986 and 1996, 194 patients underwent isolated aortic valve replacement with 21-23 no. St. Jude Medical mechanical heart valves (small sized group) and 163 patients with 27-29 no. (large sized group).
Methods. The mean age at operation was 45.04±15.90 years (range: 12-76 years) for the small sized group and 38.05±13.41 years (range: 16-68 years) for the large sized group. Preoperatively, 39.7% of the patients from the small sized group and 42.9% from the large sized group had pure aortic stenosis, 31.9% and 27.6% had pure aortic insufficiency. Most of the patients had rheumatic valve disease.
Results. The overall hospital mortality rate was 12.4% and 3.07% respectively in the small sized and large sized groups (p<0.001). The overall actuarial survival rate for 10 years was 95.33±2.73% and 93.06±3.98% respectively in the small sized group and large sized group (p>0.05). In the small sized group male sex and all complications, in large sized group age and all complications were the statistically important hospital mortality predictors (p<0.05).
Conclusions. Although, operative mortality and long term morbidity were higher in the small sized group, these changes did not reflect the actuarial survivals between the groups. Small sized valves carry some risk, but these risks do not affect long-term survival.