Influence of valve size on morbidity and mortality for patients with mechanical valve replacements (GELIA 8)
a Klinik und Poliklinik für Herz- and Thoraxchirurgie, Universität Würzburg, Würzburg, Germany
b Institute for Medical Outcome Research, Lörrach, Germany
c Herzzentrum Nordrhein-Westfalen, Kardiologische Klinik, Ruhr Universität Bochum, Bad Oeynhausen, Germany
* Correspondence: PD Dr. med. Jörg Babin-Ebell, Klinik and Poliklinik für Herz- und Thoraxchirurgie der Universität Würzburg, Josef-Schneider-Str. 6, 97080 Würzburg, Germany.
Abstract
Aims In the past most of the investigations regarding the influence of valve size on outcome after heart valve replacements were done retrospectively. The present study is the first to investigate prospectively the influence of the implanted valve size on morbidity and mortality, using a close follow-up technique.
Method and results The findings in the present study were obtained prospectively in a multicentre study (the German Experience in Low Intensity Anticoagulation [GELIA] study) conducted from 1993 to 1999. In the subgroup analysis we sought to determine whether a smaller valve size influenced morbidity or mortality after heart valve replacement. Data from 2244 patients (1765 aortic and 479 mitral valve replacements) were analyzed for morbidity. For mortality, a total of 2557 patients were eligible. Patient data were compared for all valve diameters, and for valve area index (VAI) below and above the median (median VAI for aortic valves was 1·6 cmz. m-2 and for mitral valves it was 2·44 cm2 . m–2). Only three patients fell into the categories of small VAI (aortic valves VAI <0·9 cm2. m–2; mitral valves VAI <1·3 cm2. m–2).
Conclusion The present study was unable to demonstrate an influence of the size of the implanted heart valve on mortality and morbidity, either in the mitral or in the aortic position. The St. Jude Medical valve appears to provide a sufficient valve area, even for small sizes.
Key Words: Morbidity • mortality • valve replacement • valve size