Aortic valve replacement with 23- and 25-mm mechanical valves yielded the most noteworthy anatomical and functional improvements, including significant increases in LVEF and exercise capacity (p<0.001).
Observational (n=92)
Does the size of the mechanical valve used in aortic valve replacement affect anatomical and functional improvements in the left ventricle in patients with serious aortic valve stenosis?
Aortic valve replacement with larger mechanical valves (23 and 25 mm) yields greater anatomical and functional improvements in the left ventricle compared to smaller valves, suggesting small valves should be avoided due to higher residual gradients.
p-value: p=<0.001
OBJECTIVE: To date, there is no consensus on the selection of type and size of prosthetic valve for aortic valve replacement (AVR). The aim of this study was to compare anatomical and functional changes occurring in the left ventricle after AVR with different sizes of mechanical valves. METHODS: A total of 92 patients with serious aortic valve stenosis, who underwent AVR between March 2001 and June 2008 using mechanical valves of different sizes, were retrospectively analysed. The sizes of the mechanical valves were 19, 21, 23 and 25 mm. All patients were assessed preoperatively, and at six months and in the first, third and fifth years postoperatively. The left ventricle was assessed with electrocardiography, echocardiography and telecardiography and compared in the four patient groups, constituted according to the mechanical valve size used. RESULTS: In all groups, left ventricular mass and mass index, transvalvular aortic gradient, thicknesses of the interventricular septum and posterior wall, and left ventricular endsystolic and end-diastolic diameters had decreased significantly post surgery. Left ventricular ejection fraction and exercise capacity had increased significantly (p < 0.001). The most noteworthy anatomical and functional improvements were seen in patients who had received 23- and 25-mm mechanical valves. CONCLUSION: Mechanical valve replacement should not be performed with small size valves because of the higher residual gradient.
Gokhan et al. (Thu,) conducted a observational in serious aortic valve stenosis (n=92). Aortic valve replacement with mechanical valves vs. Comparison between different valve sizes was evaluated on Anatomical and functional changes in the left ventricle (p=<0.001). Aortic valve replacement with 23- and 25-mm mechanical valves yielded the most noteworthy anatomical and functional improvements, including significant increases in LVEF and exercise capacity (p<0.001).