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

Author(s):  
Dao Quang Vinh ◽  
Nguyen Sinh Hien ◽  
Ta Hoang Tuan

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.

2020 ◽  
Vol 16 (2) ◽  
pp. 177-183
Author(s):  
Zbigniew Chmielak ◽  
Maciej Dąbrowski ◽  
Paweł Tyczyński ◽  
Krzysztof Kukuła ◽  
Ilona Michałowska ◽  
...  

Author(s):  
S. Ludwig ◽  
D. Kalbacher ◽  
N. Schofer ◽  
A. Schäfer ◽  
B. Koell ◽  
...  

Abstract Aims Transcatheter mitral valve replacement (TMVR) with dedicated devices promises to fill the treatment gap between open-heart surgery and edge-to-edge repair for patients with severe mitral regurgitation (MR). We herein present a single-centre experience of a TMVR series with two transapical devices. Methods and results A total of 11 patients were treated with the Tendyne™ (N = 7) or the Tiara™ TMVR systems (N = 4) from 2016 to 2020 either as compassionate-use procedures or as commercial implants. Clinical and echocardiographic data were collected at baseline, discharge and follow-up and are presented in accordance with the Mitral Valve Academic Research Consortium (MVARC) definitions. The study cohort [age 77 years (73, 84); 27.3% male] presented with primary (N = 4), secondary (N = 5) or mixed (N = 2) MR etiology. Patients were symptomatic (all NYHA III/IV) and at high surgical risk [logEuroSCORE II 8.1% (4.0, 17.4)]. Rates of impaired RV function (72.7%), severe pulmonary hypertension (27.3%), moderate or severe tricuspid regurgitation (63.6%) and prior aortic valve replacement (63.6%) were high. Severe mitral annulus calcification was present in two patients. Technical success was achieved in all patients. In 90.9% (N = 10) MR was completely eliminated (i.e. no or trace MR). Procedural and 30-day mortality were 0.0%. At follow-up NYHA class was I/II in the majority of patients. Overall mortality after 3 and 6 months was 10.0% and 22.2%. Conclusions TMVR was performed successfully in these selected patients with complete elimination of MR in the majority of patients. Short-term mortality was low and most patients experienced persisting functional improvement. Graphic abstract


Author(s):  
Nguyen Sinh Hien ◽  
Nguyen Minh Ngoc ◽  
Nguyen Thai Minh ◽  
Nguyen Dang Hung ◽  
Dang Quang Huy ◽  
...  

Objectives: To evaluate results of minimally invasive aortic valve replacement surgery through right thoracotomy with some techinque improvements in Hanoi Heart Hospital. Methods: Surgery was performed via a small right thoracotomy in the second intercostal space. The third rib was detached by a wedge-shaped way using sternum saw. Cannulation approaches were central or peripheral depended on patients’ condition. Preoperative, perioperative, early results and follow-up data was collected and analysed. Results: There was 48 patients in the research. Mean age was 60,94 ± 11,53 (25-82), and 52,1% was male. 29,2% of patients had peripheral vascular disease. 22,9% underwent central arterial cannulation. 3 patients (6,3%) had pericardial adhesion. There was no early mortality, 2 patients had redo surgery due to excess bleeding. 1 patients had intestinal infarction. Mean follow-up time was 13,4 months. 91,3% of patients had NYHA I. 1 patients was dead due to intracerebral hemorrhage. Conclusions: With some improvements in techniques, minimally invasive aortic valve replacement surgery through right thoracotomy gave good early and midterm results in our center.


2014 ◽  
Vol 30 (3) ◽  
pp. 256-259 ◽  
Author(s):  
Michael J. Daly ◽  
Paul H. Blair ◽  
Thomas Modine ◽  
Patrick M. Donnelly ◽  
Reuben Jeganathan ◽  
...  

1993 ◽  
Vol 1 (3) ◽  
pp. 123-128 ◽  
Author(s):  
W.R. Eric Jamieson ◽  
Alfred N. Gerein

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.


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