LONG-TERM FOLLOW-UP OF SMALL (SIZE-20 AND SIZE-21) MEDTRONIC-HALL AORTIC-VALVE PROSTHESES

Background. Our goal was to study the long-term follow-up of patients having aortic valve replacement and to focus particularly on the patie nts receiving small prostheses. Methods. Four hundred twenty-eight Med tronic-Hall valves were implanted (156 size 20 or 21 mm, 149 size 22 o r 23 mm, and 123 size 25 or 27 mm). Group 20-21 had a higher number of female patients, more associated coronary lesions, and more patients with aortic stenosis. Results. The actuarial survival rate at 8 years was 80% for group 20-21, 80% for group 22-23, and 76% for group 25-27 (p = not significant). In group 20-21, the actuarial event-free rates at 8 years were as follows: thromboembolic complications, 94%; prosthe tic valve endocarditis, 99%; reoperation, 98%; and hemorrhagic complic ations, 78%. The only factors of prognostic value in this group were a ge and associated coronary lesions. Conclusions. The durable nature of the results obtained with the Medtronic-Hall 20- and 21-mm prostheses compared with large-diameter prostheses allows the use of a simple an d reliable surgical technique and should mean that indications for rin g enlargement become rare. (C) 1997 by The Society of Thoracic Surgeon s.