Results of Isolated Valve Replacement in Hemodialysis Patients

2007 ◽  
Vol 15 (5) ◽  
pp. 386-391 ◽  
Author(s):  
Wataru Kato ◽  
Kazuyoshi Tajima ◽  
Sachie Terasawa ◽  
Keisuke Tanaka ◽  
Akihiko Usui ◽  
...  
Keyword(s):  
Survival Rate ◽  
Valve Replacement ◽  
Anticoagulation Therapy ◽  
Hemodialysis Patients ◽  
Long Term Results ◽  
Bleeding Complications ◽  
Mechanical Valves ◽  
Bileaflet Mechanical Valve ◽  
Bileaflet Mechanical Valves

Frequent bleeding complications and poor long-term results have been reported after valve replacement in hemodialysis patients. We use mainly bileaflet mechanical valves with low-dose warfarin therapy (target international normalized ratio, 1.8–2.0) in such cases. Data of 27 hemodialysis patients undergoing isolated valve replacement from 1993 to 2002 were retrospectively analyzed. Bileaflet mechanical valves were selected in 23 patients and bioprostheses in 4. Those with mechanical valves were treated with mild anticoagulation therapy. There were 3 (11.1%) early deaths due to ischemic colitis, interstitial pneumonia, and ventricular arrhythmia. There were 3 late deaths and 5 bleeding complications during follow-up. The overall survival rate was 85.2% at 3 years and 72.9% at 5 years. The survival rate of patients with mechanical valves was 82.6% at 3 years and 76.7% at 5 years. One patient with a bioprosthesis experienced structural valvular deterioration after 3 years. The results demonstrate an acceptable long-term outcome. A bileaflet mechanical valve managed with mild anticoagulation therapy is a reasonable strategy for hemodialysis patients.

scholarly journals Long-Term Results of Open Heart Surgery in Hemodialysis Patients-CABG vs. Valve Replacement-

2005 ◽  
Vol 34 (1) ◽  
pp. 9-13 ◽  
Author(s):  
Mitsuhiro Yamamura ◽  
Yuji Miyamoto ◽  
Hideki Yao ◽  
Sukemasa Mukai ◽  
Hiroe Tanaka ◽  
...  
Keyword(s):  
Valve Replacement ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Hemodialysis Patients ◽  
Long Term Results ◽  
Open Heart

Long-term results of mitral valve replacement: biological xenograft versus mechanical valves

2003 ◽  
Vol 6 (1) ◽  
pp. 30-36 ◽  
Author(s):  
H. Yao ◽  
T. Miyamoto ◽  
S. Mukai ◽  
M. Yamamura ◽  
H. Tanaka ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Long Term Results ◽  
Mechanical Valves

Long term results after prospectively randomized stentless versus conventional xenograft aortic valve replacement

2008 ◽  
Vol 56 (S 1) ◽  
Author(s):  
S Lehmann ◽  
T Walther ◽  
J Kempfert ◽  
S Leontyev ◽  
J Garbade ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Long Term Results

Pulmonary Homografts for Aortic Valve Replacement: Long-term Comparison with Aortic Grafts

2011 ◽  
Vol 14 (4) ◽  
pp. 237 ◽  
Author(s):  
Ferdinand Vogt ◽  
Anke Kowert ◽  
Andres Beiras-Fernandez ◽  
Martin Oberhoffer ◽  
Ingo Kaczmarek ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Survival Rates ◽  
Long Term Results ◽  
Rank Test ◽  
Aortic Graft ◽  
Valve Prostheses ◽  
Retrospective Comparative Study

<p><b>Objective:</b> The use of homografts for aortic valve replacement (AVR) is an alternative to mechanical or biological valve prostheses, especially in younger patients. This retrospective comparative study evaluated our single-center long-term results, with a focus on the different origins of the homografts.</p><p><b>Methods:</b> Since 1992, 366 adult patients have undergone AVR with homografts at our center. We compared 320 homografts of aortic origin and 46 homografts of pulmonary origin. The grafts were implanted via either a subcoronary technique or the root replacement technique. We performed a multivariate analysis to identify independent factors that influence survival. Freedom from reintervention and survival rates were calculated as cumulative events according to the Kaplan-Meier method, and differences were tested with the log-rank test.</p><p><b>Results:</b> Overall mortality within 1 year was 6.5% (21/320) in the aortic graft group and 17.4% (8/46) in the pulmonary graft group. In the pulmonary graft group, 4 patients died from valve-related complications, 1 patient died after additional heterotopic heart transplantation, and 1 patient who entered with a primary higher risk died from a prosthesis infection. Two patients died from non-valve-related causes. During the long-term follow-up, the 15-year survival rate was 79.9% for patients in the aortic graft group and 68.7% for patients in the pulmonary graft group (<i>P</i> = .049). The rate of freedom from reoperation was 77.7% in the aortic graft group and 57.4% in the pulmonary graft group (<i>P</i> < .001). The reasons for homograft explantation were graft infections (aortic graft group, 5.0%; pulmonary graft group, 6.5%) and degeneration (aortic graft group, 7.5%; pulmonary graft group, 32.6%).</p><p><b>Conclusion:</b> Our study demonstrated superior rates of survival and freedom from reintervention after AVR with aortic homografts. Implantation with a pulmonary graft was associated with a higher risk of redo surgery, owing to earlier degenerative alterations.</p>

scholarly journals Minimum 10-Year Clinical Outcome of Lateral Collagen Meniscal Implants for the Replacement of Partial Lateral Meniscal Defects: Further Results From a Prospective Multicenter Study

2021 ◽  
Vol 9 (5) ◽  
pp. 232596712199491
Author(s):  
Alberto Grassi ◽  
Gian Andrea Lucidi ◽  
Giuseppe Filardo ◽  
Piero Agostinone ◽  
Luca Macchiarola ◽  
...  
Keyword(s):  
Survival Rate ◽  
Case Series ◽  
Final Analysis ◽  
Activity Level ◽  
Long Term Results ◽  
Level Of Evidence ◽  
Unicompartmental Knee Arthroplasties ◽  
Tegner Score

Background: The collagen meniscal implant (CMI) is a biologic scaffold aimed at replacing partial meniscal defects. The long-term results of lateral meniscal replacement have never been investigated. Purpose: To document the clinical outcomes and failures of lateral CMI implantation for partial lateral meniscal defect at a minimum 10-year follow-up. Study Design: Case series; Level of evidence, 4, Methods: This study included 24 consecutive patients who underwent lateral CMI implantation for partial lateral meniscal defects between April 2006 and September 2009 and who were part of a previous study with a 2-year follow-up. Outcome measures at the latest follow-up included the Lysholm score, Knee injury and Osteoarthritis Outcome Score, visual analog scale (VAS) for pain, Tegner activity level, and EuroQol 5-Dimensions score. Data regarding complications and failures were collected, and patients were asked about their satisfaction with the procedure. Results: Included in the final analysis were 19 patients (16 male, 3 female) with a mean age at surgery of 37.1 ± 12.6 years and a mean follow-up of 12.4 ± 1.5 years (range, 10-14 years). Five failures (26%) were reported: 1 CMI removal because of implant breakage and 4 joint replacements (2 unicompartmental knee arthroplasties and 2 total knee arthroplasties). The implant survival rate was 96% at 2 years, 85% at 5 years, 85% at 10 years, 77% at 12 years, and 64% at 14 years. Lysholm scores at the final follow-up were rated as “excellent” in 36% (5 of 14 nonfailures), “good” in 43% (6 of 14), and “fair” in 21% (3 of 14). The VAS score was 3.1 ± 3.1, with only 16% (3 of 19 patients) reporting that they were pain-free; the median Tegner score was 3 (interquartile range, 2-5). All clinical scores decreased from the 2-year follow-up; however, with the exception of the Tegner score, they remained significantly higher compared with the preoperative status. Overall, 79% of patients were willing to undergo the same procedure. Conclusion: Lateral CMI implantation for partial lateral meniscal defects provided good long-term results, with a 10-year survival rate of 85% and a 14-year survival rate of 64%. At the final follow-up, 58% of the patients had “good” or “excellent” Lysholm scores. However, there was a general decrease in outcome scores between the short- and the long-term follow-up.

Tricuspid valve replacement with bioprostheses: long-term results and causes of valve dysfunction

2001 ◽  
Vol 71 (1) ◽  
pp. 105-109 ◽  
Author(s):  
Kiyoharu Nakano ◽  
Hatsue Ishibashi-Ueda ◽  
Junjiro Kobayashi ◽  
Yoshikado Sasako ◽  
Toshikatsu Yagihara
Keyword(s):  
Valve Replacement ◽  
Tricuspid Valve ◽  
Long Term Results ◽  
Tricuspid Valve Replacement ◽  
Valve Dysfunction

Long-term Results of Chemotherapy in 106 Cases of Lymphosarcoma and Reticulum Cell Sarcoma

1968 ◽  
Vol 54 (2) ◽  
pp. 127-134 ◽  
Author(s):  
Sergio Di Pietro
Keyword(s):  
Survival Rate ◽  
Alkylating Agents ◽  
Clinical Stage ◽  
Long Term Results ◽  
Reticulum Cell ◽  
Reticulum Cell Sarcoma ◽  
Term Survival ◽  
Cell Sarcoma ◽  
Pre Treatment

The survival rate of 106 cases of advanced lymphosarcoma and reticulum cell sarcoma that had received chemotherapy, with or without radiotherapy, between 1951 and 1962 is reported. The course of both diseases was initially highly malignant, with a median survival of 20 months for lymphosarcoma and 6 months for reticulum cell sarcoma. Cases surviving for over 3 years, however, have a good chance of long survival. Male sex and an age of under 40 (there were no cases of under 13 in our series) seem to be favorable prognostic factors. A long pre-treatment interval is favorable for lymphosarcoma and adverse for reticulum cell sarcoma. The clinical stage (3 or 4 according to the classification of Banfi et al.) does not significantly affect the prognosis of lymphosarcoma whereas in reticulum cell sarcoma survival is strongly correlated with clinical stage. Chemotherapy (with alkylating agents) yielded a 5-year survival rate of 20.8% in lymphosarcoma; with radiotherapy the rate rose to 32.3%. In reticulum cell sarcoma the 5-year survival rate was 20% for chemotherapy alone and 14.2% for chemotherapy in association with radiotherapy. Our data seem to confirm the usefulness of chemotherapy, with or without radiotherapy, in diffuse forms of lymphosarcoma and reticulum cell sarcoma, especially with regard to long-term survival.

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