Long-term follow-up after aortic valve replacement with a small aortic prosthesis

Area of Science:

• Cardiovascular Surgery
• Cardiac Valve Disease
• Prosthetic Valve Performance

Background:

• Aortic valve replacement (AVR) is crucial for aortic valvular disease.
• Implanting small aortic prostheses can lead to residual left ventricular outflow stenosis and transvalvular gradients.
• Long-term outcomes of AVR with small prostheses require further investigation.

Purpose of the Study:

• To retrospectively analyze the long-term outcomes of patients who underwent AVR with small aortic prostheses.
• To compare the clinical results between patients receiving 21 mm valves and those receiving 19 or 16 mm valves.
• To assess the impact of small prosthesis size on postoperative cardiac function and physical activity.

Main Methods:

• Retrospective analysis of 24 patients undergoing AVR.
• Division into two groups: Group A (16 patients, 21 mm valves) and Group B (8 patients, 19 or 16 mm valves).
• Comparison of preoperative cardiac function, operative procedures, and long-term follow-up data (mean 55.0 months for Group A, 51.3 months for Group B).

Main Results:

• No significant differences in preoperative cardiac function or operative procedures between groups.
• No significant differences in cardiothoracic ratio (CTR), left ventricular ejection fraction (LVEF), or left ventricular mass index (LVMI) postoperatively.
• No significant differences in New York Heart Association (NYHA) functional classification between groups, indicating similar postoperative physical activity.

Conclusions:

• Despite the use of small prostheses for AVR, good long-term postoperative outcomes were observed.
• No significant adverse effects on cardiac function or physical activity were detected in the long term.
• Careful patient follow-up remains essential after AVR, particularly when using smaller prosthetic valves.