Abstract
Background: Aortic valve replacement with mechanical valves is associated with a small but constant risk of valve thrombosis and thromboembolic and hemorrhagic complications. The surgical outcome of patients with Aortic Stenosis who had aortic valve replacement with mechanical valves is reported here.
Methods: Between January 1990 and October 1999, 275 patients underwent prosthetic valve replacement for isolated aortic stenosis. The age ranged between 13 years and 75 years and 230 were males. The cause of aortic stenosis was rheumatic in 185 patients (67.3%), followed by bicuspid aortic valve in 75 patients (27.3%) and degenerative in 15 patients (5.4%).
Results: The early mortality was 1.5%. The follow up was 96% complete and ranged from 1 to 104 months (mean 54±24.5months). Six patients (2.2%) developed prosthetic valve endocarditis. Paravalvular leak occurred in 3 (0.9%) patients. Valve thrombosis occurred in 10 patients (1.0% per patient year). The actuarial survival was 81±7% at 5 years and 64±13% at 8 years. Event free survival was 40±14% at 8 years.
Conclusion: With current operative techniques and myocardial preservation aortic stenosis patients are at low risk for surgery. However, long term survival is limited due to prosthesis related complications.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Mautner GC, Mautner SL, Cannon RO III, et al. Clinical factors useful in predicting aortic valve structure in patients >40 years age with isolated valvular aortic stenosis. Am J Cardiol 1993; 72: 194–98.
Dare AJ, Veinot JP, Edwards WD, et al. New observations on the etiology of aortic valve disease: a surgical pathologic study of 236 cases from 1990. Hum Pathol 1993; 24: 1330–38.
Turri M, Thiene G, Bortolotti U, et al. Surgical pathology of aortic valve disease: a study based on 602 specimens. Eur J Cardio Thorac Surg 1990, 4: 556–60.
David TE, Gott VL, Harker LA, et al. Mechanical valves. Ann Thorac Surg 1996; 62: 1567–70.
Akins CW. Results with mechanical cardiac valvular prostheses. Ann Thorac Surg 1995; 60: 1836–44.
Arom KV, Nicoloff DM, Kersten TE, et al. Ten years experience with the St. Jude Medical valve prosthesis. Ann Thorac Surg 1989; 47: 831–37.
Arom KV. St. Jude medical prosthesis: Another 10-year followup report. Ann Thorac Surg 1993; 56: 403–4.
Edmunds LH (Jr.), Clarke RE, Cohn LH, et al. Guidelines for reporting morbidity and mortality after cardiac valvular operations. Ann Thor Surg 1996; 62: 932–35.
Grunkemeier GL, Thomas DR, Starr A. Statistical considerations in the analysis and reporting of time — related events. Application to analysis of prosthelic valve-related thromboembolism and failure. The American Journal of Cardiology. 1977; 257–58.
Gonzalez-Juanatey JR, Garcia-Acuna JM, Vega Fernandez M, Amaro Cendon A, Castelo Fuentes V, Garcia-Bengoechea JB, et al. Influence of the size of aortic valve prosthesis on hemodynamics and change in left ventricular mass: implications for the surgical management of aortic stenosis. J Thorac Cardiovasc Surg 1996; 112: 273–80.
Wiseth R, Levang OW, Sande E, Tanger G, Skjaerpe T, Halte L. Hemodynamic evaluation by Doppler echocardiograophy of small (<21 mm) prostheses and bio prostheses in the aortic valve position. Am J Cardiol 1992;70:240–46.
Bove EL, Marvasti MA, Potts JL, Reger MJ, Zamora JL, Eich RH, et al. Rest an exercise hemodynamics following aortic valve replacement. A comparison between 19 and 21 mm Ionescu-Shiley pericardial and Carpentier — Edwards porcine valves. J Thorac Cardiovasc Surg 1985;90: 750–55.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Devagourou, V., Choudhary, S., Bhan, A. et al. Results of prosthetic valve replacement for aortic stenosis. Indian J Thorac Cardiovasc Surg 18, 80–83 (2002). https://doi.org/10.1007/s12055-002-0038-0
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12055-002-0038-0