Six-Year Experience with CarboMedics Prosthetic Heart Valves

Between July 1989 and July 1995, 89 CarboMedics prosthetic heart valves were implanted in 70 patients (38 males, 32 females) ranging in age from 13 to 54 years (mean 33 years). Forty-one of these patients underwent mitral valve replacement, 10 had aortic valve replacement, and 19 had double aortic and mitral valve replacement. Early mortality was 4.9%, 0%, and 15.8% respectively in these groups. Mean follow-up time was 3.4 years and was 95.4% complete (3 lost). There were 5 late deaths (7.7%); 1 in the mitral group, 1 in the aortic group, and 3 who had double valve replacements. Three of these late deaths were considered valve-related. The 5-year actuarial survival rates, hospital mortality excluded, were 97% for mitral, 88% for aortic, and 88% for double valve replacement. Preoperatively, 80% of the patients were in New York Heart Association functional class III or IV, whereas postoperatively, 99.5% of the patients were in class I or II. No structural failures were observed. There was 1 case of systemic embolism and 1 case of valve thrombosis, neither of these patients were taking anticoagulants. Hemorrhage was the most frequent complication; 1 of 4 events was fatal. A less intensive warfarin regimen and improvement in hepatic function may reduce hemorrhagic risk while maintaining thromboembolic protection. On the basis of this experience, the CarboMedics prosthetic heart valve appears to be an excellent mechanical prosthesis for cardiac valve replacement, in terms of hemodynamic performance and low thrombogenicity, in patients receiving anticoagulants.

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Managing Pregnancy with Post Mitral Valve Replacement Presenting Late

Nepal Journal of Obstetrics and Gynaecology ◽

10.3126/njog.v8i1.8866 ◽

2013 ◽

Vol 8 (1) ◽

pp. 50-52

Author(s):

Basanta Lamichhane ◽

N Paradhan ◽

SJ Rawal ◽

A Singh ◽

SR Bhandari ◽

...

Keyword(s):

Mitral Valve ◽

Valve Replacement ◽

Mitral Valve Replacement ◽

Heart Valves ◽

Prosthetic Heart Valves ◽

Healthy Baby ◽

Obstetrics And Gynaecology ◽

Healthy Female ◽

Ultimate Outcome ◽

Uneventful Pregnancy

With the increased awareness and emphasis of institutional delivery, there has been an increase in trend of cases of valvular heart disease with pregnancy being reported to tertiary centers. Though rare, cases like post mitral valve replacement (MVR) with pregnancy are often a challenge in terms of management with an outcome of uneventful pregnancy and healthy baby. The management of women with prosthetic heart valves during pregnancy poses a particular challenge as there are no available controlled clinical trials to provide guidelines for effective antithrombotic therapy. Here we present a case of post MVR with pregnancy with an ultimate outcome of a healthy female and uneventful vaginal delivery. Nepal Journal of Obstetrics and Gynaecology / Vol 8 / No. 1 / Issue 15 / Jan- June, 2013 / 50-52 DOI: http://dx.doi.org/10.3126/njog.v8i1.8866

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Performance by Age Groups in Biological and Mechanical Cardiac Valve Replacement

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849239700500302 ◽

1997 ◽

Vol 5 (3) ◽

pp. 130-136 ◽

Cited By ~ 1

Author(s):

Guy J Fradet ◽

WR Eric Jamieson ◽

Robert T Miyagishima ◽

A Ian Munro

Keyword(s):

Mitral Valve ◽

Valve Replacement ◽

Mitral Valve Replacement ◽

Heart Valves ◽

Age Groups ◽

Age Group ◽

Biological Prosthesis ◽

Mechanical Prostheses ◽

Valve Prostheses ◽

Biological Prostheses

A group of 1195 patients who received biological valve prostheses (mean age 57.3 years, range 8 to 85 years) and a group of 1345 patients who received mechanical heart valves (mean age 56.1 years, range 13 to 91 years) were analyzed for complications by age group (less than or equal to 54 years, 55 to 65 years, and over 65 years). The freedom from thromboembolism and anticoagulant-related hemorrhage at 8 years after aortic valve replacement was significantly higher in patients who received a biological prosthesis in all age groups. The freedom from thromboembolism and anticoagulant-related hemorrhage at 8 years after mitral valve replacement was significantly higher in patients who received a biological prosthesis in the age groups less than or equal to 54 years and over 65 years. The freedom from all valve-related complications at 5 and 8 years after aortic or mitral valve replacement showed the same trend of greater freedom from complications in biological prostheses patients compared with mechanical prostheses in most age groups. However, freedom from valve-related reoperation, mortality, and residual morbidity for aortic and mitral valve replacement for all age groups was not significantly different. These results show that biological prostheses can be considered for patients aged 55 years and older. The prostheses by age group or position at 8 years were not differentiated by valve-related reoperation, mortality, and residual morbidity. t 8 years there is a demonstrated price to pay for a presumed increase in longevity for patients with mechanical valves in the aortic position, reflected by an increase in thromboembolism and anticoagulant-related hemorrhage in all age groups.

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Long-term outcomes after reoperation for mitral paravalvular leaks: a single-centre experience

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezaa331 ◽

2020 ◽

Author(s):

Shin Yajima ◽

Satsuki Fukushima ◽

Kizuku Yamashita ◽

Yusuke Shimahara ◽

Naoki Tadokoro ◽

...

Keyword(s):

Mitral Valve ◽

Valve Replacement ◽

Mitral Valve Replacement ◽

Prosthetic Valve Endocarditis ◽

Paravalvular Leak ◽

Class Iii ◽

Long Term Outcomes ◽

Low Cardiac Output Syndrome

Abstract OBJECTIVES We aimed to analyse the pathology of paravalvular leak (PVL), and determine the long-term outcomes of redo mitral valve replacement and risk factors of all-cause mortality. METHODS Seventy-nine patients (mean age 70 ± 9 years; 54 female, 68%) who underwent redo mitral valve replacement for mitral PVL between January 2000 and May 2019 were retrospectively reviewed. Indications for PVL intervention were haemolytic anaemia (57/79, 72%), New York Heart Association class III/IV congestive heart failure (56/79, 71%) and prosthetic valve endocarditis with PVL (2/79, 3%). RESULTS PVL most commonly occurred at lateral sectors (42/79, 55%). Early mortality occurred in 2 patients (3%) due to low cardiac output syndrome. Two patients (3%) had residual PVL at discharge. Sixteen patients (23%) developed late PVL (mean follow-up, 3.4 ± 2.9 years), among whom 11 (69%) developed PVL at same area as that preoperatively. Additionally, 9 patients (56%) developed PVL at lateral sectors in late follow-up. At 1, 5 and 10 years, the survival rate was 93%, 72% and 45%; rate of freedom from cardiac death was 96%, 92% and 78%; and rate of freedom from PVL recurrence was 94%, 82% and 54%, respectively. Chronic kidney disease was the only risk factor in the multivariate analysis for mortality [P = 0.013; hazard ratio 4.0 (1.4–11.0)]. CONCLUSIONS Surgery for mitral PVL confers reasonable early and long-term outcomes. Greater attention to the anterolateral annulus may help prevent PVL.

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Choice of echocardiography method for postoperative evaluation of mitral valve replacement with a mechanical prosthesis

Archives of Cardiovascular Diseases ◽

10.1016/s1875-2136(08)73694-5 ◽

2008 ◽

Vol 101 (4) ◽

pp. 204-212 ◽

Cited By ~ 2

Author(s):

G. Greffe ◽

R. Henaine ◽

O. Metton ◽

J. Nloga ◽

P. Wautot ◽

...

Keyword(s):

Mitral Valve ◽

Valve Replacement ◽

Mitral Valve Replacement ◽

Postoperative Evaluation ◽

Mechanical Prosthesis

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Prevalence and clinical significance of mild paraprosthetic ring leaks and left atrial spontaneous echo contrast detected on transesophageal echocardiography three months after isolated mitral valve replacement with a mechanical prosthesis

The American Journal of Cardiology ◽

10.1016/0002-9149(93)91082-s ◽

1993 ◽

Vol 72 (11) ◽

pp. 848-850 ◽

Cited By ~ 5

Author(s):

Daniel Skudicky ◽

John Skoularigis ◽

Mohammed R. Essop ◽

Christian Rothlisberger ◽

Pinhas Sareli

Keyword(s):

Mitral Valve ◽

Transesophageal Echocardiography ◽

Valve Replacement ◽

Clinical Significance ◽

Mitral Valve Replacement ◽

Left Atrial ◽

Mechanical Prosthesis ◽

Spontaneous Echo Contrast

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Transseptal Transcatheter Mitral Valve Replacement Using Balloon-Expandable Transcatheter Heart Valves

JACC Cardiovascular Interventions ◽

10.1016/j.jcin.2017.06.069 ◽

2017 ◽

Vol 10 (19) ◽

pp. 1905-1919 ◽

Cited By ~ 29

Author(s):

Marina Urena ◽

Dominique Himbert ◽

Eric Brochet ◽

Jose Luis Carrasco ◽

Bernard Iung ◽

...

Keyword(s):

Mitral Valve ◽

Valve Replacement ◽

Mitral Valve Replacement ◽

Heart Valves ◽

Transcatheter Mitral Valve Replacement

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Usefulness and Safety of Rivaroxaban in Patients Following Isolated Mitral Valve Replacement With a Mechanical Prosthesis

The American Journal of Cardiology ◽

10.1016/j.amjcard.2018.06.015 ◽

2018 ◽

Vol 122 (6) ◽

pp. 1047-1050 ◽

Cited By ~ 8

Author(s):

André R. Durães ◽

Yasmin de S.L. Bitar ◽

Maria Luiza G. Lima ◽

Caroline C. Santos ◽

Igor S. Schonhofen ◽

...

Keyword(s):

Mitral Valve ◽

Valve Replacement ◽

Mitral Valve Replacement ◽

Mechanical Prosthesis

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Antithrombotic Treatment after Transcatheter Heart Valves Implant

Seminars in Thrombosis and Hemostasis ◽

10.1055/s-0037-1607457 ◽

2018 ◽

Vol 44 (01) ◽

pp. 038-045 ◽

Cited By ~ 15

Author(s):

Sabato Sorrentino ◽

Gennaro Giustino ◽

Kamilia Moalem ◽

Ciro Indolfi ◽

Roxana Mehran ◽

...

Keyword(s):

Mitral Valve ◽

Valve Replacement ◽

Mitral Valve Replacement ◽

Heart Valves ◽

Severe Aortic Stenosis ◽

Feasibility Studies ◽

Standard Of Care ◽

Bleeding Events ◽

Transcatheter Heart Valve ◽

Transcatheter Mitral Valve Replacement

AbstractTranscatheter heart valve replacement technology was introduced as alternative to surgery for the growing high-risk profile population. Developed first, aortic valve replacement (TAVR) became a standard of care for patients with severe aortic stenosis at high operative risk, with a potential future use also for low-risk subjects. In the last decade, a multitude of transcatheter mitral valve replacement (TMVR) devices have been developed for the treatment of severe mitral regurgitation, with encouraging results coming from first-in-man and feasibility studies. As for biological surgical-type valves, transcatheter implanted valves still preserve the risk of thrombosis and embolic events and anticoagulation- or antiplatelet-based strategies are the most widely used options. Unfortunately, these last remain recommended on the basis of empirical or not widely validated evidence. Therefore, given the exponential rise of TAVR and TMVR procedures, it is important to identify the optimal antithrombotic strategies that best fit the risk of thromboembolic and bleeding events. Hereafter, this review evaluates the current guidelines, trials, and observational data discussing antithrombotic strategy after transcatheter aortic or mitral valve replacement.

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