Bioprostheses and Mechanical Prostheses Predictors of Performance

2000 ◽  
Vol 8 (2) ◽  
pp. 121-126 ◽  
Author(s):  
WR Eric Jamieson ◽  
Eva Germann ◽  
Guy J Fradet ◽  
Samuel V Lichtenstein ◽  
Robert T Miyagishima
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Artery Bypass ◽  
Mechanical Valve ◽  
Mechanical Prostheses ◽  
Related Mortality ◽  
Overall Mortality

From 1975 to 1995, 4200 patients had bioprosthetic valve replacements (2240 aortic, 1607 mitral, 353 multiple) and 2038 had mechanical valve replacements (747 aortic, 928 mitral, 363 multiple). Freedom from major thromboembolism or both major thromboembolism and hemorrhage for aortic and mitral valve replacement at 15 years was significantly greater for bioprostheses than mechanical prostheses. Freedom from valve-related mortality and reoperation for both aortic and mitral valve replacements was the same for bioprostheses and mechanical prostheses. Advancing age increased overall mortality (all positions), valve-related mortality (aortic, mitral), major thromboembolism (aortic), thromboembolism and hemorrhage (aortic, mitral) but decreased reoperation (all positions). Coronary artery bypass grafting increased overall mortality (aortic, mitral) but not valve-related mortality, and it decreased reoperation rate (aortic, mitral). Overall mortality was not influenced by valve type in aortic or multiple valve replacement but it was decreased by bioprostheses in mitral valve replacement. Valve type did not influence valve-related mortality (all positions). Mechanical valves decreased reoperation only for aortic valve replacement but they increased major thromboembolism with and without hemorrhage for both aortic and mitral replacements. There is support for bioprostheses in aortic valve replacement and mechanical prostheses in mitral valve replacement but for neither in multiple valve replacements.

Mitroflow Pericardial Bioprosthesis: Experience to Seven Years

1993 ◽  
Vol 1 (3) ◽  
pp. 123-128 ◽  
Author(s):  
W.R. Eric Jamieson ◽  
Alfred N. Gerein
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Prosthetic Valve ◽  
Clinical Performance ◽  
Prosthetic Valve Endocarditis ◽  
Structural Valve Deterioration ◽  
Related Mortality

Between 1983 and 1987, the Mitroflow pericardial prosthesis was implanted in 99 patients, ranging in age from 28 to 94 years (mean 62.8 years). Early mortality was 6.1% (6 patients), and late mortality was 4.8% per patient-year (22 patients). Total cumulative follow-up was 458 patient-years (mean 4.6 years). At 7 years, patient survival was 62% for aortic valve replacement and 63% for mitral valve replacement. The overall rate of valve-related complications was 7.4% per patient-year (34 events): thromboembolism, 2.8%; antithromboembolic-relatedhemorrhage, 1.1%; prosthetic valve endocarditis, 0.7%; non-structural dysfunction, 0.7%; and structural valve deterioration, 2.8%. At 7 years, freedom from thromboembolism was 80.3%, and freedom from prosthetic valve endocarditis was 95.5%. At 5 and 7 years, freedom from structural valve deterioration was 93.4% and 69.7%, respectively. At 5 years, freedom from structural valve deterioration was 97.3% for aortic valve replacement (AVR), 86.6% for mitral valve replacement (MVR), and 100% for multiple valve replacement (MR). At 7 years, freedom from structural valve replacement was 84.6% and 61.3% for AVR and MVR, respectively. At 7 years, overall freedom from reoperation was 68.2%; from valve-related mortality, 81.4%; from valve-related residual morbidity, 97.4%; and from treatment failure (valve-related mortality and residual morbidity), 79.0%. At 7 years, the Mitroflow pericardial bioprosthesis has provided satisfactory clinical performance, especially in the aortic position, with an acceptable freedom from structural valve deterioration.

Results of Valve Replacement Surgery with Mechanical Prostheses

1982 ◽  
Vol 5 (1) ◽  
pp. 27-32 ◽  
Author(s):  
A. Pellegrini ◽  
B. Peronace ◽  
E. Marcazzan ◽  
C. Rossi ◽  
T. Colombo
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Replacement Surgery ◽  
Post Surgery ◽  
Mechanical Prostheses ◽  
Valve Replacement Surgery

The clinical study is reported of the results of heart valve replacement surgery with a new pyrolytic carbon tilting disc prosthesis manufactured in Italy. From March 1977 to January 1981, at the «De Gasperis» Cardiosurgery Center, this prosthesis has been implanted in 644 patients: 283 for mitral valve replacement, 240 for aortic valve replacement, and 121 for the replacement of both mitral and aortic valves. To have a sufficiently long period of post-surgery follow-up, we considered the results of 207 patients (124 cases of isolated mitral valve replacement and 83 cases of isolated aortic valve replacement), who underwent surgery consecutively from March 1977 to December 1979. The hospital mortality was 10.5% for mitral valve replacement and 4.8% for aortic valve replacement. All patients who were discharged from hospital, except 2, were subjected to clinical, electrocardiographic, phonocardiographic, ecocardiographic and radiological checks. The average follow-up period was approximately 20 months: clinical results were satisfactory. The probability of survival, expressed by actuarial curve, was, three years after surgery, 94% for patients who underwent mitral valve replacement and 97.5% for those who underwent aortic valve replacement. The probability of embolism was, three years after surgery, 8.5% for patients with mitral replaced and 5% for aortic. Even if further confirmations are needed the mortality rate and the probability of embolism related to this new prosthesis, are lower, over the same period of follow-up, than that found in the groups of patients who underwent valve replacement surgery, at the same Center, with Starr-Edwards and Björk-Shiley prostheses. The phonocardiographic and ecocardiographic characteristics of this new prosthesis were also investigated.

scholarly journals Surgical Outcomes in Native Valve Infectious Endocarditis: The Experience of the Cardiovascular Surgery Clinic – Cluj-Napoca Heart Institute

2015 ◽  
Vol 88 (3) ◽  
pp. 338-342 ◽  
Author(s):  
Adrian Molnar ◽  
Ioan Muresan ◽  
Catalin Trifan ◽  
Dana Pop ◽  
Diana Sacui
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Mitral Valve Repair ◽  
Mechanical Valve ◽  
Infectious Endocarditis ◽  
Valve Repair ◽  
Native Valve

Background and aims. The introduction of Duke’s criteria and the improvement of imaging methods has lead to an earlier and a more accurate diagnosis of infectious endocarditis (IE). The options for the best  therapeutic approach and the timing of surgery are still a matter of debate and require a close colaboration between the cardiologist, the infectionist and the cardiac surgeon.Methods. We undertook a retrospective, descriptive study, spanning over a period of five years (from January 1st, 2007 to December 31st, 2012), on 100 patients who underwent surgery for native valve infectious endocarditis in our unit.Results. The patients’ age varied between 13 and 77 years (with a mean of 54 years), of which 85 were males (85%). The main microorganisms responsible for IE were: Streptococcus Spp. (21 cases – 21%), Staphylococcus Spp. (15 cases – 15%), and Enterococcus Spp. (9 cases – 9%). The potential source of infection was identified in 26 patients (26%), with most cases being in the dental area (16 cases – 16%). The lesions caused by IE were situated in the left heart in 96 patients (96%), mostly on the aortic valve (50 cases – 50%). In most cases (82%) we found preexisting endocardial lesions which predisposed to the development of IE, most of them being degenerative valvular lesions (38 cases – 38%). We performed the following surgical procedures: surgery on a single valve - aortic valve replacement (40 cases), mitral valve replacement (19 cases), mitral valve repair (1 case), surgery on more than one valve – mitral and aortic valve replacement (20 cases), aortic and tricuspid valve replacement (1 case), aortic valve replacement with a mechanical valve associated with mitral valve repair (5 cases), aortic valve replacement with a biological valve associated with mitral valve repair (2 cases), and mitral valve replacement with a mechanical valve combined with De Vega procedure on the tricuspid valve (1 case). In 5 patients (5%) the bacteriological examination of valve pieces excised during surgery was positive. In 3 cases it matched the germ identified in the hemocultures, and in 2 cases it evidenced another bacterium.Conclusion. The overall mortality of 5% is well between the limits presented in literature, being higher (30%) in patients who required emergency surgery. For the patients who return into our clinic with prosthetic valve endocarditis, the mortality after surgery was even higher (50%). 

scholarly journals Transcatheter aortic valve replacement in patients with previous mitral valve replacement. A systematic study

2020 ◽  
Vol 16 (2) ◽  
pp. 177-183
Author(s):  
Zbigniew Chmielak ◽  
Maciej Dąbrowski ◽  
Paweł Tyczyński ◽  
Krzysztof Kukuła ◽  
Ilona Michałowska ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Systematic Study ◽  
Transcatheter Aortic Valve Replacement ◽  
Transcatheter Aortic Valve

Patient-Specific Approach to Mitral Valve Replacement in Infants Weighing 10 kilograms or less

2019 ◽  
Vol 10 (3) ◽  
pp. 304-312
Author(s):  
Kathryn Mater ◽  
Julian Ayer ◽  
Ian Nicholson ◽  
David Winlaw ◽  
Richard Chard ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Surgical Techniques ◽  
Somatic Growth ◽  
Mechanical Valve ◽  
Left Ventricular ◽  
Patient Specific ◽  
Mechanical Prostheses

Background: Mitral valve replacement (MVR) is the only option for infants with severe mitral valve disease that is not reparable; however, previously reported outcomes are not always favorable. Our institution has followed a tailored approach to sizing and positioning of mechanical valve prostheses in infants requiring MVR in order to obtain optimal outcomes. Methods: Outcomes for 22 infants ≤10 kg who have undergone MVR in Sydney, Australia, from 1998 to 2016, were analyzed. Patients were at a mean age of 6.8 ± 4.1 months (range: 0.8-13.2 months) and a mean weight of 5.4 ± 1.8 kg at the time of MVR. Most patients (81.8%) had undergone at least one previous cardiac surgical procedure prior to MVR, and 36.4% had undergone two previous procedures. Several surgical techniques were used to implant mechanical bileaflet prostheses. Results: All patients received bileaflet mechanical prostheses, with 12 receiving mitral prostheses and 10 receiving inverted aortic prostheses. Surgical technique varied between patients with valves implanted intra-annularly (n = 6), supra-annularly (n = 11), or supra-annularly with a tilt (n = 5). After a mean follow-up period of 6.2 ± 4.4 years, the survival rate was 100%. Six (27.3%) patients underwent redo MVR a mean of 102.2 ± 10.7 months after initial MVR. Four (18.2%) patients required surgical reintervention for development of left ventricular outflow tract obstruction and three (13.6%) patients required permanent pacemaker placement during long-term follow-up. Conclusions: The tailored surgical strategy utilized for MVR in infants at our institution has resulted in reliable valve function and excellent survival. Although redo is inevitable due to somatic growth, the bileaflet mechanical prostheses used displayed appropriate durability.

scholarly journals Comments of results after surgical replacement of mechanical mitral and aortic valve in children at Hanoi Heart Hospital

2021 ◽  
Vol 35 ◽  
pp. 26-33
Author(s):  
Dao Quang Vinh ◽  
Nguyen Sinh Hien ◽  
Ta Hoang Tuan
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Objective Assessment ◽  
Open Heart Surgery ◽  
Early Results ◽  
Number Of Patients ◽  
Heart Hospital

Objective: Assessment of early results after surgical treatment of mechanical mitral valve and aortic valve replacement in children at Hanoi Heart Hospital from 2004 to June 2019. Methods: Analysis and evaluation based on data collected from patients undergoing surgery and from the results of follow-up examination. Results: The total number of patients was 50, in which 34 cases of simple mechanical mitral valve replacement, 16 cases of simple mechanical aortic valve replacement. Average age of surgery: 7.58 ± 6.01 years (The lowest age is 7 months, the highest is 15 years). Male: 29 patients (58%), female: 21 patients (42%). Ultrasound before discharge and after 3 months, we found similar results: mean EF: mechanical  mitral valve: 56.28 ± 10.67 %; Aortic valve: 54.72 ± 9.66% .Mean pressure : Mitral valve: 3.18 ± 1.25; Aortic valve: 12.12 ± 3.25 mmHg. INR index: mitral valve : 2.58 ± 1.20; Aortic valve: 2.34 ± 0.92. Complications of valve replacement: 2 cases of mitral valve replacement after surgery 3 years and 4 years; There was 1 case of aortic valve  5 years after surgery. Death immediately after surgery:  mitral valve: 2 cases (5.88%); aortic valve: 1 case (6.25%); Late death: After 2 years, there was 1 case of death after mitral valve replacement; After 4 years, there was 1 case of death after aortic valve replacement. Conclusion: The results of heart valve replacement surgery in children are positive. It is necessary to have better equipment and experience in open heart surgery in low-birth-weight children in order to operate the disease as early and effectively as possible, in which the treatment of complications of heart failure and post-operative coagulopathy should be considered important.

Sign in / Sign up

Export Citation Format

Share Document