Browse by author
Lookup NU author(s): Stephen Clark, Colin Hilton, Michael Holden
Full text for this publication is not currently held within this repository. Alternative links are provided below where available.
Background. There is the potential for iatrogenic aortic stenosis and poor quality of life when small aortic valve bioprostheses are used in elderly patients. The alternative is enlarging the aortic annulus to accommodate larger size prostheses, increasing operative mortality. It was hoped that bovine pericardial valves would improve hemodynamic performance in the smaller valve sizes. Methods. To determine long-term results and in vivo hemodynamic performance of small-size aortic Carpentier-Edwards bovine pericardial valves (Perimount) in elderly patients, we analyzed our follow-up and echocardiographic data from patients 75 years of age or older receiving isolated 19-mm and 21-min Perimount valves. Ninety-four patients with a mean age of 77 +/- 2.2 years were followed for 12 years. Seventeen patients with 19-mm and 25 patients with 21-min Perimount valves underwent transthoracic echocardiograms. Results. Operative mortality was 6.3% (6 of 94).Twelve-year survival was 82.7%. Freedom from thromboembolism was 86.9% at 12 years. Two patients had anticoagulation-related bleeding. Overall New York Heart Association class decreased from 3 +/- 1 to 1.6 +/- 0.7 at the end of follow-up. Hemodynamic performances were satisfactory in both 19-mm and 21-mm Perimount valves, with low peak and mean transvalvular gradients and good effective orifice areas, orifice area indices, and performance indices. Conclusions. Perimount aortic valve in the small aortic annulus has yielded excellent long-term results and hemodynamic performances. Perimount is a very satisfactory option in elderly patients. Implantation of a Perimount bioprosthesis avoids enlargement of the small aortic annulus, reducing mortality and morbidity associated with this procedure. (C) 2003 by The Society of Thoracic Surgeons.
Author(s): Vitale N, Clark SC, Ramsden A, Hasan A, Hilton CJ, Holden MP
Publication type: Article
Publication status: Published
Journal: Annals of Thoracic Surgery
Year: 2003
Volume: 75
Issue: 1
Pages: 35-39
ISSN (print): 0003-4975
ISSN (electronic): 1552-6259
Publisher: Elsevier
URL: http://dx.doi.org/10.1016/S0003-4975(02)04165-6
DOI: 10.1016/S0003-4975(02)04165-6
Altmetrics provided by Altmetric
