Standard 19mm St Jude aortic valves in patients with body surface less than 1.7m(2)

Although new models of bileaflet valves with improved orifice have been dev ised, aortic valve replacement with 19 mm prostheses still raises concerns about long term effects of residual transprosthetic gradient. We reviewed our experience with 19 mm standard model St Jude prostheses in 68 patients operated on between January 1983 and December 1995. Clinical la te assessment was performed to evaluate the incidence of valve related comp lications. Postoperative echocardiography was performed to evaluate hemodyn amic performance of the prostheses. Mean body surface area was 1.66+/-0.14m(2). Late postoperative peak gradien t was 53.85+/-7.16 mmHg; mean gradient was 34.80+/-5.55 mm Hg; effective or ifice area was 1.93+/-0.05 cm(2). Thirteen-year actuarial survival has been 90.89 +/- 0.6%, thirteen-year freedom from embolism 89.41 +/- 0.7% and fre edom from hemorrhage 98.25 +/- 0.02%. No case of prosthetic endocarditis, t hrombosis, or reoperation was observed during follow-up.