Key result
17-mm mechanical AVR shows ~63% 10-year survival and reduced LV mass index.
Why the study?
The study was conducted to investigate the long-term clinical and hemodynamic outcomes after aortic valve replacement with a 17-mm mechanical valve.
Does aortic valve replacement with a 17-mm mechanical valve provide acceptable long-term clinical and hemodynamic outcomes in patients with a small aortic annulus?
Cohort (n=80)
No
Does aortic valve replacement with a 17-mm mechanical valve provide acceptable long-term clinical and hemodynamic outcomes in patients with a small aortic annulus?
Aortic valve replacement with a 17-mm mechanical valve provides acceptable long-term survival and significant left ventricular mass index reduction in elderly patients with a small aortic annulus.
May support 17-mm mechanical AVR in elderly small-annulus patients; extends observational data but leaves randomized comparisons open.
BACKGROUND: We investigated the long-term clinical and hemodynamic outcomes after aortic valve replacement (AVR) with a 17-mm mechanical valve. METHODS AND RESULTS: at discharge and occurred in 25 patients (31%). The median follow-up period was 8.7 years (100% complete). Overall in-hospital mortality was 2.5% (2 patients) with 27 late deaths (34%). The 5- and 10-year survival rates were 78.7% and 63.0%, respectively. Peripheral arterial disease and concomitant mitral valve repair were independent predictors of late mortality. The 5- and 10-year freedom from major adverse valve-related events (MAVRE) rates were 91.6% and 83.5%, respectively. PPM at discharge did not affect long-term survival, freedom from MAVRE, or freedom from heart failure. Echocardiographic data at follow-up revealed a significant reduction in the mean left ventricular mass index (LVMI). LVMI reduction observed at follow-up was similar between patients with and without PPM. CONCLUSIONS: AVR with the 17-mm mechanical prosthesis had acceptable long-term clinical and hemodynamic outcomes. Significant reduction in LVMI was observed regardless of PPM.
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Okamura et al. (2020) conducted a cohort in Aortic stenosis (n=80). Aortic valve replacement with St. Jude Medical Regent mechanical valve was evaluated on 10-year overall survival. Aortic valve replacement with a 17-mm mechanical prosthesis demonstrated acceptable long-term outcomes, including a 10-year survival rate of 63.0% and significant left ventricular mass index reduction.
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