Performance by Age Groups in Biological and Mechanical Cardiac Valve Replacement

1997 ◽  
Vol 5 (3) ◽  
pp. 130-136 ◽  
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.

Next generation russian biological prosthesis “UniLin” for mitral valve replacement: first experience

2017 ◽  
Vol 59 (2) ◽  
pp. 98-104
Author(s):  
A.M. Karas'kov ◽  
S.I. Zheleznev ◽  
N.V. Rogulina ◽  
A.V. Sapegin ◽  
Yu.N. Odarenko ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Next Generation ◽  
Biological Prosthesis

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.

Mitral Valve Replacement Using Mechanical Prostheses in Children: Early and Long-Term Outcomes

2012 ◽  
Vol 33 (4) ◽  
pp. 639-645 ◽  
Author(s):  
Hyung-Tae Sim ◽  
Seung-Cheol Lee ◽  
Hong Ju Shin ◽  
Jeong-Jun Park ◽  
Tae-Jin Yun ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Long Term Outcomes ◽  
Mechanical Prostheses

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.

Results of Randomized Mitral Valve Replacement with Mechanical Prostheses after 15 Years

1992 ◽  
Vol 15 (10) ◽  
pp. 611-616 ◽  
Author(s):  
H.D. Schulte ◽  
D. Horstkotte ◽  
W. Bircks ◽  
B.E. Strauer
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Cumulative Risk ◽  
Bleeding Complications ◽  
Severe Bleeding ◽  
Mechanical Prostheses ◽  
Valve Thrombosis ◽  
Long Term Follow Up

Between 1974 and 1976 150 consecutive patients (pts) were operated on for isolated mitral valve replacement (MVR). Björk-Shiley (BS), Lillehei-Kaste (LK), and Starr-Edwards (SE) (type 6210) prostheses were implanted at random. All survivors were prospectively followed by regular clinical examinations every 6 to 12 months for 15 years. The mean follow-up time was 14.8 years. A constant subjective improvement after 15 years was reported in 62% of pts with BS, 30% with LK, and 49% with SE. The cumulative 14-year survival rate was 0.62 ± 0.13 (BS), 0.56 ± 0.16 (SE), and 0.54 ± 0.15 (LK), respectively. Late mortality was due to thromboembolic events (n=3), bleeding complications (n=3), congestive heart failure (n=7), documented arrhythmias or sudden death (n=6). Thrombotic valve thrombosis (1 BS, 1 LK, 2 SE) required reoperations. Linearized cumulative rates after 14 years for thromboembolic complications were 14.2 ± 3.1 (BS), 15.8 ± 3.7 (SE), 24.3 ± 4.2 (LK). The cumulative risk of severe bleeding complications was not different: BS: 35.8, LK: 35.2, SE: 34.3. During the first years of observation no significant differences between these mechanical prostheses could be observed, however, after 14 years of long-term follow-up the cumulative event-free rates were more favorable for the BS prosthesis.

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

2017 ◽  
Vol 10 (19) ◽  
pp. 1905-1919 ◽  
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

scholarly journals Results after mitral valve replacement with mechanical prostheses in young children

2010 ◽  
Vol 139 (5) ◽  
pp. 1189-1196.e2 ◽  
Author(s):  
Bahaaldin Alsoufi ◽  
Cedric Manlhiot ◽  
Brian W. McCrindle ◽  
Zohair Al-Halees ◽  
Ahmed Sallehuddin ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Young Children ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Mechanical Prostheses

Antithrombotic Treatment after Transcatheter Heart Valves Implant

2018 ◽  
Vol 44 (01) ◽  
pp. 038-045 ◽  
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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