Early-Term Hemodynamic Performance And Clinical Results of 19-mm st. Jude Medical Regent Valve In Patients With Small Aortic Annulus Undergoing Dual Valve Replacement: A Retrospective Study

Background: The prosthesis selection in patients with small aortic annulus undergoing aortic valve replacement (AVR) has always been a challenge, especially in dual valve replacement (DVR, combined aortic and mitral valve replacement). The present study aimed to analyze early-term hemodynamic parameters of 19-mm St. Jude Medical Regent ( SJMR19 ) valve in patients with small aortic annulus undergoing DVR. Methods: Between January 2015 to December 2020, 54 patients with small aortic annulus who underwent DVR were divided into two groups: SJMR19 valve group (n=30) and 21-mm mechanical (M21) valve group (n=24). The perioperative and early-term hemodynamic data were collected and analyzed. Results: A significant difference in terms of maximum transaortic flow velocity (Vav max), maximum transaortic pressure gradient (PGav max), left ventricular mass index (LVMi) and left ventricular mass (LVM) was observed postoperatively in both groups. The postoperative left ventricular ejection fraction (LVEF) was significantly higher while the LVM and LVMi was evidently decreased in the SJMR19 group, compared with the M21 group. In order to confirm the influencing factors on postoperative LVEF, a multiple linear regression analysis model was established by including all candidate variables and the implanted valve type was identified in the multivariate analysis as an independent predictor for postoperative LVEF. Conclusions: The postoperative cardiac function and hemodynamic parameters was improved both in the SJMR19 and M21 groups. The postoperative LVEF, LVM and LVMi were better in the SJMR19 group compared with those of the M21 group. And the implanted valve type might possess the predictive value of postoperative LVEF in patients with small aortic annulus undergoing DVR.