Standard versus hemodynamic plus 19-MM St Jude Medical aortic valves

Objective: We reviewed our experience with aortic valve replacement using 1 9-mm St Jude Medical prostheses (St Jude Medical, Inc, St Paul, Minn) in 11 9 patients, among which 68 (group A) had a Standard model and 51 (group B) had a Hemodynamic Plus model. Methods: Comparison between the 2 models included analysis of early and lat e mortality and all valve-related complications. Postoperative echocardiogr aphy was performed to evaluate the hemodynamic performance of both prosthet ic models. Laboratory tests were performed to evaluate the amount of red bl ood cell damage caused by the transprosthetic turbulent flow. Results: Average body surface area was 1.66 +/- 0.14 m(2) in group A and 1. 65 +/- 0.16 m(2) in group B (P = .72). There was no statistically significa nt differ ence between the 2 groups in terms of preoperative variables (sex , cardiac rhythm, body surface area, preoperative gradients, and New York H eart Association class). Five-year follow-up was 100% complete. Although gr oup A patients had significantly higher postoperative peak and mean gradien ts (P = .0001) and a lower effective orifice area (P = .0001), no statistic al differences were found in terms of late (5-year) survival (P = .6) and p ostoperative complications (P = .09). Moreover, postoperative left ventricu lar mass was found to be similar in the 2 groups (P = .18). Hematologic eva luation did not show any significant difference between the 2 groups as to incidence of hemolysis. Conclusions: Aortic valve replacement with 19-mm aortic prostheses in patie nts with a body surface area of less than 1.7 m(2) allows good results. Alt hough Hemodynamic Plus models have better hemodynamic results, no significa nt difference was found in terms of clinical results and clinical hemolysis .