The CarboMedics "Top-Hat" supraannular prosthesis

Abstract Background . The CarboMedics "Top-Hat" supraannular prosthesis was designed to permit the implantation of a larger prosthesis. Methods . Between June 1993 and November 1996, 127 patients (average age, 61.8 ± 10.2 years) received a CarboMedics "Top-Hat" supraannular aortic prosthesis. The average follow-up was 15.7 months, and all surviving patients underwent echocardiographic study. This group is compared with 656 patients in whom a standard CarboMedics prosthesis was implanted and also with 2,927 patients who received other aortic prostheses. Results . Using the standard and the supraannular sizers, there was an average increase of one size in favor of the supraannular prosthesis: 18.9 ± 2.8 mm standard versus 20.8 ± 2.6 mm supraannular ( p Conclusions . Using the CarboMedics supraannular prosthesis allows implantation of a larger prosthesis compared with the standard CarboMedics prosthesis or other models. This advantage is especially important in patients with a small aortic root.