Raja Parvez Akhtar, Abdul Rehman Abid, Mumraiz Salik Nuqshband, Jawad Sajid Khan.
Clinical outcome of double valve repalcement with or without small aortic prosthesis.
J Coll Physicians Surg Pak Jan ;22(10):617-21.

Objective: To determine the effect of aortic prosthesis size on clinical outcome of patients undergoing double cardiac valve replacement (DVR). Study Design: A quasi-experimental study. Place and Duration of Study: Cardiac Surgery Department, Punjab Institute of Cardiology, Lahore, Pakistan, from February 1996 to December 2008. Methodology: One hundred and forty patients undergoing double cardiac valve replacement were divided into 2 groups. Group I, 75 (53.6%) receiving aortic prosthesis size of ² 21 mm. Group II, 65 (46.4%) having aortic prosthesis of > 21 mm size. All patients were prospectively followed-up for 12 years in order to study mortality and valve related complications. Results: There were 94 males (67.1%) and 46 females (32.9%) with a mean age of 25.5 ± 10 years. In Group I, 21 patients (28%) had aortic valve replacement (AVR) with 19 mm valve size and 54 patients (72%) had 21 mm size valves implanted. In Group II, 39 patients (60%) had AVR with 23 mm size valves implanted followed by 16 (24.6%) who received 25 mm size valves. Posterior mitral leaflet was preserved in 15 patients (20%) in Group I and 14 (21.5%) in Group II. Mortality was seen in 13 patients (9.3%); of these 5 (3.6%) were in Group I and 8 (5.7%) were in Group II. Nine patients (6.4%) had incomplete follow-up (In Group I, 2 patients died in ICU, 2 died within 30 days of admission and one was a late death. In Group II, 1 patient died in ICU, 1 within 30 days of admission and 6 within 1 year of operation). Conclusion: Double valve replacement with implantation of small aortic prosthesis has similar overall mortality as compared to patients having larger sized aortic valves.

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