Background. Valve replacement in small aortic root remains a surgical chall
enge. The objective of this study was to compare results of the 19-mm biopr
osthesis with those of larger prostheses in the elderly.
Methods. The 443 patients, 70 years of age and older, who underwent aortic
valve replacement with Carpentier-Edwards pericardial bioprostheses were re
viewed.
Results. There were 93 patients with a mean age of 76 +/- 4 years with impl
antation of 19-mm prostheses and 350 patients with a mean age of 75 +/- 4 y
ears with larger bioprostheses. Associated aortoplasty was performed in 10
patients (11%) with 19-mm bioprostheses and in 8 patients (2%) with larger
bioprostheses (p = 0.001). There were 11 deaths (12%) within 30 days of sur
gery in patients with 19-mm prostheses and 22 deaths (6%) among those with
larger prostheses (p = 0.1). The 7-year survival rate averaged 61% +/- 7% i
n patients with 19-mm prostheses and 67% +/- 4% in those with larger prosth
eses (p = 0.8). The 7-year freedom rates from all valve-related events aver
aged 96% +/- 2% and 93% +/- 2%, respectively [p = 0.6).
Conclusions. Aortic valve replacement with the 19-mm Carpentier-Edwards per
icardial bioprosthesis offers excellent midterm results in the elderly. (C)
2001 by The Society of Thoracic Surgeons.