Long-Term Follow Up in Patients Receiving a Small Aortic Valve Prosthesis
Ken-ichi Arata MD, Yoshifumi Iguro MD, Hiroshi Masuda MD, Tamahiro Kinjo MD, Hitoshi Matsumoto MD, Gouichi Yotsumoto MD, Ryuzo Sakata MD, Akira Taira MD

Concern persists regarding long-term effects of aortic valve replacement (AVR) in the small aortic root. Twenty-eight patients (21 females; mean age 54.1 ± 11.7 years; mean body surface area (BSA) 1.39 ± 0.07 m²) who underwent AVR with a 19 mm mechanical valve over 10 years ago, were followed up. Long-term echocardiography was performed in 18 of 21 survivors. Follow up was complete for up to 19.2 years (mean 11.4 years); cumulative follow up was 318.1 patient-years. Actuarial survival at 5, 10 and 15 years was 88.5 ± 6.3%, 72.0 ± 9.0% and 72.0 ± 9.0%, respectively. NYHA class showed satisfactory improvement. Long-term echocardiography showed significant reductions in left ventricular (LV) wall thickness and mass index compared with preoperatively, and a negative correlation between the reduction in LV wall thickness and BSA. The use of a 19 mm aortic mechanical prosthesis in patients with a small aortic annulus was viable, especially when their BSA was <1.45 m².