Comparing Study Of GK Mechanical Valves Replacement With Carbomedics Valves Replacement For Patients With Small Aortic Root

Objective: To evaluate the heart function in patients with small aortic root after homemade GK-double-leaflet valve replacement, and comparing them with patients after CarbomMedics valve replacement ,and to find the reason leading to PPM.Methods: Form August 2006 to December 2008,31 patients with heart valve disease and with small aortic root were divided into 2 groups.16 patients received homemade GK double leaflet valve ,and 15 patients received CarbomMedics valve. All patients had preoperative body surface area in accordance with its appropriate choice of models of artificial valve ,then their EOAI expected value was larger than 0.85 c㎡/㎡. Left ventricular ejection fraction (LVEF),left ventricular fractional shortening(LVFS), the indexed effective orifice area(EOAI)and pressure gradients across aortic valve , were studied by Doppler echocardiography before operation and 6 months after operation. The results were compared between patients who received homemade GK double leaflet valve and patients who received CarboMedics valve.Results: There was no one die in the 6 months following up. Comparing with those before operation , there was a significant increase in LVEF,LVFS of all patients 6 months after operation . There was a significant reduction in the pressure gradients across aortic valve .Comparing with CarboMedics valve ,the GK double leaflet valve had lower pressure gradients across aortic valve. 24 cases of patients'EOAI were larger than 0.85 c㎡/㎡,7 cases of patients'EOAI were between 0.85 c㎡/㎡ and 0.65 c㎡/㎡.Analysis of the reasons for the formation of PPM ,there were 3 patients received GK-double-leaflet valve ,cause of weight gained pose-operation,4 patients received Carbomedics valve,2 of them cause of weigh gained post-operation,2 of them cause of occurring proliferation-like change post-operation .Because the EOAI of these patients received GK-double-leaflet valve was larger than those who received CarboMedics valve, these patients recoveried better postoperative.Conclusion: patients with GK valves could experience a satisfactory improvement and early stage survival cause of large effective orifice area ,lower pressure gradients across aortic valve and it did not occure proliferation-like change post-operation .