Background and Objectives
The aim of the present study is to report the early and mid-term clinical and haemodynamic
results of the St Jude Medical Regent 19-mm aortic mechanical prothesis (SJMR-19).
Materials and Methods
Between January 2002 and January 2012, 265 patients with aortic valve disease underwent
AVR (Aortic Valve Replacement) with a SJMR-19 (St Jude Medical Regent Nr.19). There
were 51 males. Mean age was 67.5 ± 12.72 years and mean body surface area (BSA) was 1.67 ± 0.14 m2. Thirty-six patients required annulus enlargement. The mean follow-up was 34.5 ± 18.8 months (range 6–60 months). All patients underwent echocardiographic examination at
discharge and within 1 year after surgery.
Results
There were 14 (5.3%) hospital deaths. Six of the hospital deaths were identified in
patients undergoing reoperation, significantly higher than patients undergoing first
time operation (p = 0.0001). Also the postoperative mortality was significantly higher in patients undergoing
annulus enlargement versus patients not requiring annulus enlargement (p = 0.02). The mean transprosthesis gradient at discharge was 19 ± 9 mmHg. At 6 months follow-up the mean NYHA FC class was 1.6 ± 0.5 significantly lower than preoperatively 2.4 ± 0.75 (p < 0.0001). The M-TPG was 15.2 ± 6.5 mmHg within 1 year after surgery. Left ventricular mass (LVM) and indexed left ventricular
mass (LVMi) were significantly lower than preoperatively The actuarial survival and cumulative
freedom from reoperation at 1, 2 and 3 years follow-up were 99.5%, 97.5%, 96.7% and
99.2%, 96.5%, 94.5% respectively. The cumulative actuarial free-events survival at
4 years was 92%. The Cox model identified age (p = 0.015), LVEF ≤ 35% (p = 0.043), reoperation (p = 0.031), combined surgery (p = 0.00002), and annulus enlargement (p = 0.015) as strong predictors for poor actuarial free-major events survival.
Conclusions
The SJMR-19 offers excellent postoperative clinical, haemodynamic outcome and LVMi reduction in patients with small aortic annulus. These data demonstrate that the
modern St Jude small mechanical protheses do not influence the intermediate free-reoperation
survival.
Keywords
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Article info
Publication history
Published online: March 28, 2017
Accepted:
February 14,
2017
Received in revised form:
January 23,
2017
Received:
April 24,
2015
Identification
Copyright
© 2017 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
