Replacement of the st jude medical regent valve in the aortic position with a continuous suture technique in the small aortic root.

BACKGROUND: The aim of this study is to review the strategy of performing aortic valve replacement (AVR) by using the St. Jude Medical (SJM) Regent valve with a continuous suture technique in patients with a small aortic root.

METHODS: Forty-six patients with small aortic annulus underwent AVR by using 19 or 21 mm SJM Regent valves. There were 15 males and 31 females. The mean age of the patients was 51.8 ± 12.4 years. The aortic annular diameter was 20.2 ± 0.9 mm. AVR procedures were performed with continuous suture technique using SJM Regent valves under standard cardiopulmonary bypass. Echocardiaographic data were collected before operation, at discharge, and at a follow-up time, respectively.

RESULTS: The intraoperative course was uneventful and there was no operative mortality. The implanted SJM Regent valves consisted of 21 mm valves in 15 patients and 19 mm valves in 31 patients. Echocardiography at 5.6 ± 1.3 months after operation showed a significant increase in the mean effective orifice area index (0.97 ± 0.24 cm(2) /m(2) ), decrease in the mean and peak transvavluar pressure gradient (12.5 ± 5.9 and 22.3 ± 9.6 mmHg), and decrease in the mean left ventricular mass index (106 ± 41.3 g/m(2) ). Moderate prosthesis-patient mismatch (PPM) (effective orifice area index between 0.65 and 0.85 cm(2) /m(2) ) was present in three patients and no severe PPM (effective orifice area index <0.65 cm(2) /m(2) ) occurred at discharge and during follow-up.

CONCLUSION: Replacement of SJM Regent valve with a continuous suture technique maybe a good option to prevent PPM in the aortic position.