Clinical outcome of double valve repalcement with or without small aortic prosthesis

To determine the effect of aortic prosthesis size on clinical outcome of patients undergoing double cardiac valve replacement [DVR]. A quasi-experimental study. Cardiac Surgery Department, Punjab Institute of Cardiology, Lahore, Pakistan, from February 1996 to December 2008. 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 /= 21 mm size. All patients were prospectively followed-up for 12 years in order to study mortality and valve related complications. 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]. Double valve replacement with implantation of small aortic prosthesis has similar overall mortality as compared to patients having larger sized aortic valves