Clinical outcome of double valve repalcement with or without small aortic prosthesis

• Published in: Journal of the College of Physicians and Surgeons--Pakistan Vol. 22; no. 10; pp. 617 - 621
• Main Authors: Akhtar, Raja Parvez, Abid, Abdul Rehman, Nuqshband, Mumraiz Salik, Khan, Jawad Sajid
• Format: Journal Article
• Language: English
• Published: Pakistan 01.10.2012
• Subjects: Adult; Aged; Aortic Valve - surgery; Cardiopulmonary Bypass; Echocardiography, Doppler; Female; Follow-Up Studies; Heart Valve Diseases - mortality; Heart Valve Diseases - surgery; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation - adverse effects; Heart Valve Prosthesis Implantation - instrumentation; Humans; International Normalized Ratio; Male; Middle Aged; Mitral Valve - surgery; Pakistan - epidemiology; Postoperative Complications - etiology; Postoperative Complications - mortality; Prospective Studies; Prosthesis Design; Rheumatic Heart Disease - mortality; Rheumatic Heart Disease - surgery; Survival Rate; Time Factors; Treatment Outcome; Pakistan
• ISSN: 1681-7168
• DOI: 10.2012/JCPSP.617621

To determine the effect of aortic prosthesis size on clinical outcome of patients undergoing double cardiac valve replacement (DVR). A quasi-experimental study. Cardiac Surgery Department, Punjab Institute of Cardiology, Lahore, Pakistan, from February 1996 to December 2008. One hundred and forty patients undergoing double cardiac valve replacement were divided into 2 groups. Group I, 75 (53.6%) receiving aortic prosthesis size of ² 21 mm. Group II, 65 (46.4%) having aortic prosthesis of > 21 mm size. All patients were prospectively followed-up for 12 years in order to study mortality and valve related complications. There were 94 males (67.1%) and 46 females (32.9%) with a mean age of 25.5 ± 10 years. In Group I, 21 patients (28%) had aortic valve replacement (AVR) with 19 mm valve size and 54 patients (72%) had 21 mm size valves implanted. In Group II, 39 patients (60%) had AVR with 23 mm size valves implanted followed by 16 (24.6%) who received 25 mm size valves. Posterior mitral leaflet was preserved in 15 patients (20%) in Group I and 14 (21.5%) in Group II. Mortality was seen in 13 patients (9.3%); of these 5 (3.6%) were in Group I and 8 (5.7%) were in Group II. Nine patients (6.4%) had incomplete follow-up (In Group I, 2 patients died in ICU, 2 died within 30 days of admission and one was a late death. In Group II, 1 patient died in ICU, 1 within 30 days of admission and 6 within 1 year of operation). Double valve replacement with implantation of small aortic prosthesis has similar overall mortality as compared to patients having larger sized aortic valves.