Medium-Term Outcome With Small Size ATS Medical Valves in Aortic Position

Records of 33 patients (group 1) who received 19-mm or 21-mm ATS aortic valve prostheses were retrospectively reviewed and compared with those of 26 patients who received 25-mm ATS valves (group 2). Group 1 patients were younger (20 ± 2 years versus 43 ± 15 years) and had a smaller mean body surface area (1.6 m2 versus 1.83 m2). Valve pathology was usually congenital aortic stenosis in group 1 and rheumatic in group 2. There was no operative mortality. The mean postoperative Doppler resting gradient was higher in group 1 (21 mm Hg versus 7 mm Hg). Total follow-up was 294 patient-years. There was no perivalvular leak, valve thrombosis, or endocarditis in either group. In group 2, there was 1 anticoagulant-related hemorrhage and 1 late death due to congestive heart failure. We concluded that in spite of the higher transprosthetic gradient, 19-mm and 21-mm ATS aortic valve prostheses performed satisfactorily in adult patients with a body surface area of less than 1.6 m2. This valve can be used in a small aortic annulus as an alternative to performing an annular enlargement procedure.