Mitroflow Synergy Prostheses for Aortic Valve Replacement: 19 Years Experience With 1,516 Patients
|
|
- Dorthy Carroll
- 6 years ago
- Views:
Transcription
1 Mitroflow Synergy Prostheses for Aortic Valve Replacement: 19 Years Experience With 1,516 Patients Kazutomo Minami, MD, Armin Zittermann, PhD, Sebastian Schulte-Eistrup, MD, Heinrich Koertke, MD, and Reiner Körfer, MD Department of Cardiothoracic Surgery, Heart Center Northrhine-Westfalia, Ruhr University of Bochum, Bad Oeynhausen, Germany Background. Pericardial prostheses have been used as valvular substitutes since They combine excellent hemodynamic characteristics with a low risk of valve failure during long-term observation. The aim of this article is to describe the clinical long-term performance of the Mitroflow Synergy pericardial valve (Sorin Group Inc, Mitroflow Division, Vancouver, Canada) in the aortic position for as long as 19 years. Methods. Data were obtained between February 1985 and April 2004 from patients with aortic heart valve replacements (n 1,464) or from patients with replacements of existing prosthetic aortic valves (n 52). The age group distributions are less than 70 years (n 175); 70 to 74 years (n 462); 75 to 79 years (n 532); 80 to 84 years (n 273); and greater than or equal to 85 years (n 74). The cause of the aortic valve lesions was combined (insufficiency and stenosis) in the majority of patients (62.4%). Concomitant procedures were performed in 897 patients (59.2%) and coronary artery bypass grafting was the most common (53.5%). Mean follow-up was years. Total follow-up was 8,408 patient-years. Results. The early mortality (30 days) was 6.6% (n 99) and late deaths were 60.8% (n 921). Actuarial event-free rates at 5, 10, and 15 years of follow-up are given as mean standard error for endocarditis: , , and , respectively; embolism: , , and , respectively; bleeding: , , and , respectively; structural valve deterioration: , , and , respectively; and reoperation: , , and , respectively. The rate of endocarditis, structural valve degeneration, and reoperation was lower in patients 75 years of age and older compared with younger patients, whereas embolism occurred more frequently in elderly than in younger patients. Conclusions. Adverse events after implantation of Mitroflow aortic bioprosthesis rarely occurred during the first 5 years after valve replacement. The results of the prosthesis indicates reliable long-term morbidity rates and good durability in patients 75 years of age and older. (Ann Thorac Surg 2005;80: ) 2005 by The Society of Thoracic Surgeons The Mitroflow pericardial valve bioprosthesis (Sorin Group Inc, Mitroflow Division, Vancouver, Canada) was introduced into clinical use in This is a second generation bioprosthesis made of a single sheet of glutaraldehyde-preserved bovine pericardium mounted on the outside of a flexible Dacron-covered Delrin stent. Due to its design characteristics, an unimpeded leaflet opening and blood flow occurs, which results in an excellent hemodynamic performance [1 4] and a proven superiority when compared with other pericardial bioprostheses [5]. Extensive clinical results of aortic valve replacement with the Mitroflow pericardial bioprosthesis have been performed [6 13]. These studies recommended the implantation of such bioprosthesis in patients older than 70 years of age. Accepted for publication April 27, Address correspondence to Dr Minami, Department of Cardiothoracic Surgery, Heart Center NRW, University of Bochum, Georgstrasse 11, Bad Oeynhausen, Germany; kminami@hdz-nrw.de. We have been using this valve for aortic replacement since 1985, especially for the application in the small aortic annulus. We have already reported long-term durability and superior hemodynamics of the bioprosthesis at 7-year and 12-year follow-ups [14, 15]. The aim of this article is to report the clinical results of 19 years experience with an extended patient population. Material and Methods Patients This retrospective report summarizes data obtained between February 1985 and April 2004 from patients with an aortic heart valve replacement at the Heart Center North Rhine Westfalia in Bad Oeynhausen, Germany. We included only those patients who had a Mitroflow Synergy valve implantation through November 1999 in our data analysis in order to achieve a sufficient follow-up period. A total of 1,516 patients with a mean age at implant of 75.6 years (range, 16 to 92 years) were 2005 by The Society of Thoracic Surgeons /05/$30.00 Published by Elsevier Inc doi: /j.athoracsur
2 1700 MINAMI ET AL Ann Thorac Surg MITROFLOW SYNERGY PROSTHESES FOR AORTIC VALVE REPLACEMENT 2005;80: included in our data analysis. Inclusion criteria were an aortic valve replacement (n 1,464) or a replacement of an existing prosthetic aortic valve (reoperations, n 52). We also included patients with active endocarditis at the time of implant in this report (n 9). Standard operative procedures were applied for aortotomy and valve removal using crystalloid cardioplegia solution (Custodiol HTK, Koehler Chemie GmbH, Alsbach-Hahnlein, Germany). The implantation technique for the Mitroflow Synergy bioprosthesis was similar to those of other aortic bioprostheses with single mattress sutures. ages as follows: less than 70 years, 70 to 74 years, 75 to 79 years, 80 to 84 years, and greater than or equal to 85 years. The log-rank test was used to test for differences in complication rates and survival rates of specific subgroups. A p value 0.05 was considered statistically significant. The risks of adverse events (ie, deaths or morbid events that occurred postoperatively) were estimated using linearized rates (percent per patient-year). They were calculated as the number of late events divided by the cumulative late postoperative patientyears (pt-yrs) and were expressed as a percentage. Study Valve The Mitroflow Synergy valve is a bioprosthetic heart valve consisting of bovine pericardium leaflets that are glutaraldehyde treated and mounted around a flexible stent. From February 1985 until July 1992, the patients were provided with valve type 11 (n 497). In May 1992, we started to use valve type 12 (n 1,024). Valve size distribution was 19 mm (n 192), 21 mm (n 629), 23 mm (n 605), 25 mm (n 78), and 27 mm (n 12). Methods We used the computer program FileMaker Pro 4 to assess the preoperative, intraoperative, and postoperative raw data. We retrospectively assessed all adverse events related to the heart valve prosthesis, such as bleeding, endocarditis, embolism, leak, tear, valve degeneration, and explantation that occurred during the follow-up interval. Adverse events were classified based on the Food and Drug Administration s Heart Valve Guidance [16], The Society of Thoracic Surgeons and the American Association of Thoracic Surgeons Guidelines for Reporting Mortality and Morbidity after Cardiac Valvular Operations [17], and the Proposal for Reporting Thrombosis, Embolism, and Bleeding after Heart Valve Replacement [18]. Every 2 years, we called the patients by telephone in order to assess New York Heart Association (NYHA) functional class and survival. In those patients who had died during the follow-up period, we requested the medical report from the general practitioner or emergency hospital to determine the cause of death. Causes of death were classified into those with evidence of valverelated causes, such as endocarditis or valve degeneration; potentially valve-related causes, such as stroke and sudden death; cardiovascular-related causes, such as heart failure, myocardial infarction, and cardiac arrest; and other causes, such as renal failure, lung failure, diabetes mellitus, infection, neoplasm, and unknown causes. Statistics Statistical evaluations were performed with the Statistical Package for Social Sciences, version 11 (SPSS, Inc, Chicago, IL). Categorical variables were reported using the number (n) and percent of observations. Continuous variables were expressed as mean values with standard error. Complication rates and survival rates were calculated with the Kaplan-Meier product-limit estimator. For data analysis, patients were grouped according to their Results The baseline and clinical characteristics of the patients are given in Table 1. The majority of patients were female (70.2%). Moreover, most of the patients were aged 70 years or older. The cause of the aortic valve lesions was mixed in the majority of patients, whereas only 33.8% had aortic insufficiency and 3.8 % had only aortic stenosis. A large number of patients had concomitant diagnoses such as hypertension (50.9%), coronary artery disease (48.2%) with myocardial infarction (15.0%), diabetes mellitus (20.5%), renal failure (13.5%), and cerebrovascular disease with a history of stroke (3.9%). Of the 1,516 patients, 897 underwent concomitant surgical procedures (Table 1). Coronary aortic bypass grafting was the most Table 1. Baseline Characteristics of the Patients at Enrollment (n 1,516) Parameter Number Percent Gender Male Female 1, Age (y) Aortic Lesion Stenosis Insufficiency Mixed Concomitant Diagnoses Stroke Diabetes mellitus Myocardial infarction Coronary heart disease Renal insufficiency Hypertension Concomitant procedures Coronary artery bypass grafting Intraaortic ballon pumping Ventricular assist device Mitral valve replacement
3 Ann Thorac Surg MINAMI ET AL 2005;80: MITROFLOW SYNERGY PROSTHESES FOR AORTIC VALVE REPLACEMENT Table 2. Mortality and Survival Estimates Causes of Death Survival (%) 1701 Operative Period 30 Days 1 Year 2 Year 5 Year 10 Year 15 Year All causes Evident valve related Potentially valve related Cardiovascular related Others Unknown frequently performed concomitant procedure. Fifty-six patients had an additional mitral valve replacement. The average follow-up period was years (range, 0.0 to 19.3 years). In total, the 1,516 patients accrued 8,408 pt-yrs of observation. As of database closure, 1,320 patients had completed 1 year of follow-up, 759 patients had completed 5 years of follow-up, 138 had completed 10 years of follow-up, and 11 had achieved 15 years of follow-up. Forty-five patients (2.97%) were considered lost to follow-up. No intraoperative deaths occurred. Ninety-nine deaths (6.56%) occurred within 30-days of valve replacement. None of these patients died because of evident valverelated complication. Six causes were potentially vale related (stroke, n 4; sudden death, n 2). Fifty five deaths were cardiovascular related (cardiac decompensation, n 42; myocardial infarction, n 13) and 16 deaths were caused by other reasons (gastrointestinal failure, n 8; multiple organ failure, n 5; infections, n 3). Twenty-two causes of death were unknown. Nine hundred and twenty-one late deaths were reported during the follow-up (60.8% of all patients). Forty-six deaths (5.0%) were classified as evident valve-related causes, 267 deaths (28.8%) had cardiovascular-related causes, 304 deaths (33.0%) were classified as others including 108 potentially valve-related deaths that had occurred (11.75%; 27 sudden deaths and 81 cases of stroke), whereas in 196 deaths (21.3%) the causes were unknown. When all-cause mortality is considered, overall survivals at 1 year and at 5 years were 87.4% and 64.5%, respectively. Table 2 reports the freedom from all-cause mortality and evident valve-related mortality by different follow-up period. Evident valve-related mortality was less than 5% within 5 years of aortic valve replacement and less than 20% within 10 years of valve replacement. In patients who were younger than 70 years, the risk of evident valve-related death began to increase 5 years after valve implantation compared with patients who were 70 years and older (Fig 1). However, in the patient groups aged 70 to 75 years and more than 75 years, the course of the survival curves was very similar during the first 10 years after valve implantation. Functional improvement of the implant patients was documented by a marked decrease in NYHA classification. Preoperatively, 1,359 patients (89.6%) of the entire cohort were in either class III or IV; 135 (8.9%) were in class II, and 22 (1.5%) were in class I. Postoperative NYHA classification was available from 778 patients. The last NYHA assessment was performed at a mean time of years after implant. At that time, 288 patients (37.0%) were in class I, 344 (44.2%) in class II, 121 (15.6%) in class III, and 25 (3.2%) in class IV. In our cohort of 1,516 patients, 393 clinically significant valve-related adverse events occurred. In detail, 26 patients developed a bleeding event (0.3% per pt-yrs); embolism was diagnosed in 68 patients (0.8% per pt-yrs); endocarditis occurred in 52 patients (0.6% per pt-yr); and 29 additional patients had a paravalvular leakage (0.3% per pt-yr). Among these patients, 84 had a structural valve deterioration. A subset of 33 patients of these 84 with structural valve deterioration developed a tear (0.4% per pt-yrs). The valve was explanted in 101 patients. Of these 101 patients, 11 patients died within 30 days of explantation. Four deaths were classified as evident valve-related causes, 4 as cardiovascular-related causes, 2 as other causes, and 1 as an unknown cause. In 251 patients, more than one valve-related complica- Fig 1. Long-term Kaplan-Meier survival estimates for evident valverelated death in patients with Mitroflow Synergy aortic bioprostheses according to patient age.
4 1702 MINAMI ET AL Ann Thorac Surg MITROFLOW SYNERGY PROSTHESES FOR AORTIC VALVE REPLACEMENT 2005;80: tion was observed. Most frequently, a bleeding complication occurred in combination with embolism (n 60). Moreover, the bioprosthesis had to be explanted because of valve degeneration in 51 patients and because of a tear in 28 patients. In 1,265 patients (83.4%), no valve-related complication occurred during the follow-up period. Of these 1,265 patients, 758 patients died during the observation period so that they definitively did not experience a valve-related complication. Endocarditis, embolism, valve degeneration, tear, and explantation were all significantly associated with age (Fig 2). However, although endocarditis, valve degeneration, tear, and explants were less frequent in elderly patients when compared with younger patients, embolism occurred more often in the elderly patients than in the younger ones. Bleeding events, occurrence of a leak, and myocardial infarction were seen not to be age related (data not shown; p values to 0.824). Adverse events were rarely seen within the first 5 years of valve replacement (Table 3). Thereafter, especially structural valve deterioration began to increase. After 15 years of follow-up, 4 of the remaining 11 patients with bioprostheses showed structural deterioration. In parallel with the increase in valve degeneration after a follow-up period of 5 years, the percentage of explants began to increase after that time, too. We have also performed separate statistical analysis for the valve types 11 and 12. Our data analysis showed similar age-dependent trends in complication rates for the two models (data not shown). Anticoagulation was performed with coumarin derivatives from the second day to as many as 6 weeks or as many as 3 months in the case of sinus rhythm. Thereafter, anticoagulation was usually stopped. During the follow-up period, antithrombotic therapy was reported for only 7 patients. These patients received coumarin derivatives in a dose that allowed them to achieve an international normalized ratio target range of 2.0 to 3.0. We did not treat this cohort of patients with platelet aggregation inhibitors. Comment This report demonstrates that the Mitroflow bioprosthesis shows reliable durability and low long-term morbidity. Considering the mean age of the study population of 75.6 years, the 5-year survival of 64.5% of our cohort of patients is a good result. If one computes the relative survival of the Mitroflow patients compared with the general life expectancy of 75-, 80-, and 85-year-old male and female Germans, the ratios are 0.52 to 0.69 for female patients and 0.58 to 0.91 for male patients [19]. Despite these relatively low ratios, it should be mentioned that evident valve-related deaths only contributed 5% to the total number of deaths. Relatively few deaths occurred from potentially valve-related events such as sudden death (3%). Moreover, the potentially valve-related event of lethal stroke (8.8%) may have had various other reasons. It is noteworthy that in 1998 stroke was identified as the cause of death for 4.25% of all Germans who died between the ages of 65 and 75 years and for 8.37% of all patients who were older than 75 when they died [20]. These data indicate that in our cohort the majority of deaths caused by stroke may not be related to the Mitroflow bioprosthesis. Compared with mechanical heart valves, bioprostheses have the advantage of not requiring anticoagulation, but the disadvantage of more frequent structural valve degeneration. There is evidence from recently performed studies that implantation of bioprostheses can induce a xenograft-specific immune response. However, the immune response against bioprostheses may be reduced and durability may be extended by procedures that diminish the presence of immunologically relevant molecules [21]. The results presented of 19 years experience with a large number of patients support earlier recommendations to implant the Mitroflow bioprosthesis only in elderly patients [6 13]. Figures 2A 2E indicate that implantations should be rigorously restricted to patients older than 75 years. This recommendation is based on the finding that especially in patients who are younger than 75 years of age, the probability of freedom from endocarditis, tear, and valve degeneration is only high during the first 5 years after valve implantation, and the risk of valve explantation increases after that time. Moreover, in elderly patients the probability of valve degeneration, endocarditis, and tear remains relatively low during the second 5 years after valve implantation. The agerelated differences in complication rates may be due to the fact that younger patients are more physically active and exert more stress on the pericardial tissue. Also as shown by our results, a high percentage of the patients who are older than 75 years of age will have died because of non valve-related reasons before a valve-related event occurs. It is well known that embolism is a serious complication in elderly subjects, even in those patients without biological heart valve prostheses. This may be due to hypertension, atrial fibrillation, and at least in part to an increased risk of dehydration caused by agerelated changes in kidney function, thirst perception, body water content, and homeostatic capacity [22]. Figure 2B indicates that the risk of embolism after valve implantation is highest in the patients who are older than 85 years of age. However, it is noteworthy that a high proportion of subjects in this age group (27%) also usually report drinking amounts of less than 1 liter [22]. It has also been shown that the proportion of 27% of the very old patients is markedly higher compared with younger patients (75 to 84 years, 15%; 65 to 74 years, 8%) [22]. In our study the probability of freedom from embolism is very high in patients who are younger than 70 years of age during the first years after valve implantation. In contrast, the risk of an embolic event already begins to increase during the first years after valve implantation in the patients who are older than 75 years of age and older than 80 years of age (Fig 2B). Data indicate that the risk of embolism may be more related to age than to the implantation of
5 Ann Thorac Surg MINAMI ET AL 2005;80: MITROFLOW SYNERGY PROSTHESES FOR AORTIC VALVE REPLACEMENT 1703 Fig 2. Occurrence of valve-related complications according to patient age: (A) endocarditis, (B) embolism, (C) tear, (D) structural valve degeneration, and (E) valve explantation.
6 1704 MINAMI ET AL Ann Thorac Surg MITROFLOW SYNERGY PROSTHESES FOR AORTIC VALVE REPLACEMENT 2005;80: Table 3. Patient Morbidity and Freedom From Adverse Events Adverse Event Freedom from Event (%) Number Operative Period 30 Days 1 Year 2 Year 5 Year 10 Year 15 Year Endocarditis Embolism Bleeding Valve leak Valve tear a Structural valve deterioration Explant a Tear is a subset of structural valve deterioration events. the bioprosthesis. Similarly with an increased risk of body dehydration, the risk of embolism obviously begins to increase when a critical age of approximately 77 to 80 years is reached. The observed relations argue for the possibility to improve drinking behavior by selective educational measures and to recommend platelet inhibitors after valve implantation. The number of patients who received bioprostheses with valve sizes less than or equal to 25 mm was relatively small. Because of geometric reasons, the 10-year freedom from structural valve degeneration is approximately 30% lower in the Mitroflow bioprosthesis with valve sizes greater than or equal to 25 mm compared with valve sizes less than 25 mm [15]; we have implanted only very few such bioprostheses during the last 10 years. The use of the Mitroflow bioprosthesis, especially for patients with small annuli also explains the reason for the relatively high percentage of female patients in our study cohort. In patients with larger annuli (eg, in a significant number of male patients), we implanted the Hancock bioprothesis (Medtronic Inc, Minneapolis, MN). This study has some limitations. Follow-up was retrospectively performed, NYHA functional class was obtained by telephone interview, and clinical outcomes such as morbidity and mortality were obtained by review of death reports filled out by personnel. This may have limited the detection of valve-related pathology. Moreover, structural valve failure was detected only if a patient required reoperation. Patients who did not undergo reoperation, despite having structural valve failure, have not been included. This could have resulted in an underestimation of the rate of structural valve deterioration. In summary, the Mitroflow bioprosthesis is a reliable choice when an aortic heart valve is required, especially in patients over 75 years of age who have a small aortic annulus. References 1. Gonzales-Juanatey JR, Acuna JM, Amaro A, et al. Doppler echocardiographic comparison of small (19 mm) bileaflet and pericardial heart valve prostheses in the aortic position. Scand J Thorac Cardiovasc Surg 1995;29: Reichenspurner H, Weinhold C, Nollert G, et al. Comparison of porcine biological valves with pericardial valves a 12-year clinical experience with 1123 bio-prostheses. Thorac Cardiovasc Surg 1995;43(1): Reul H, Giersiepen M, Schindehutte H, Effert S, Rau G. Comparative in vitro evaluation of porcine and pericardial bioprostheses. Z Kardiolol 1986;75(Suppl 2): Minami K, Schereika S, Kortke H, Gleichmann U, Korfer R. Long term follow-up of Mitroflow pericardial valve prostheses in the small aortic annulus. J Cardiovasc Surg (Torino) 1993;34(3): Pelletier LC, Carrier M. In: Acar J, Bodnar E, eds. Textbook of acquired heart valve disease, vol II. London: ICR Publishers, 1995: Loisance D, Zouari M, Leandri J, Hillion ML, Cachera JP. The Mitroflow pericardial valve. First five years of follow-up evaluation. ASAIO Trans 1989;35(3): Loisance DY, Mazzucotelli JP, Bertrand PC, Deleuze PH, Cachera JP. Mitroflow pericardial valve: long-term durability. Ann Thorac Surg 1993;56(1): Moggio RA, Pooley RW, Sarabu MR, Christiana J, Ho AW, Reed GE. Experience with the Mitroflow aortic bioprosthesis. J Thorac Cardiovasc Surg 1994;108(2): Pomar JL, Jamieson WR, Pelletier LC, Gerein AN, Castella M, Brownlee RT. Mitroflow pericardial bioprosthesis: clinical performance to ten years. Ann Thorac Surg 1995;60 (Suppl 2):S305 9; discussion S Pomar JL, Jamieson WR, Pelletier LC, Castella M, Germann E, Brownlee RT. Mitroflow pericardial bioprosthesis experience in aortic valve replacement or 60 years of age. Ann Thorac Surg 1998;66(Suppl 6):S Reber D, Birnbaum DE, Tollenaere P, Eschenbruch E. Long-term results after aortic valve replacement with the Mitroflow pericardial valve. J Cardiovasc Surg 1996; 37(Suppl 1): Thulin LI, Thilen UJ, Kymle KA. Mitroflow pericardial bioprosthesis in the aortic position. Low incidence of structural valve deterioration in elderly patients during an 11-year follow-up. Scand Cardiovasc J 2000;34(2): Mazzucotelli JP, Bertrand PC, Loisance DY. Durability of the Mitroflow pericardial valve at ten years. Ann Thorac Surg 1995;60 (Suppl 2):S Minami K, Schereika S, Kortke H, Gleichmann U, Korfer R. Long term follow-up of Mitroflow pericardial valve prostheses in the small aortic annulus. J Cardiovasc Surg 1993;34(3): Minami K, Boethig D, Mirow N, et al. Mitroflow pericardial valve prosthesis in the aortic position: an analysis of longterm outcome and prognostic factors. J Heart Valve Dis 2000;9(1):
7 Ann Thorac Surg MINAMI ET AL 2005;80: MITROFLOW SYNERGY PROSTHESES FOR AORTIC VALVE REPLACEMENT 16. Johnson DM, Sapirstein W. FDA s requirements for in-vivo performance data for prosthetic heart valves. J Heart Valve Dis 2000;3: Edmunds LH Jr, Clark RE, Cohn LH, Grunkemeier GL, Miller DC, Weisel RD. Guidelines for reporting morbidity and mortality after cardiac valvular operations. Ad Hoc Liaison Committee for Standardizing Definitions of Prosthetic Heart Valve Morbidity of The American Association for Thoracic Surgery and The Society of Thoracic Surgeons. J Thorac Cardiovasc Surg 1996;112: Bodnar E, Butchart EG, Bamford J, Besselaar AM, Grunkemeier GL, Frater RW. Proposal for reporting thrombosis, 1705 embolism and bleeding after heart valve replacement. J Heart Valve Dis 1994;3: Federal Statistical Office. Statistical Yearbook. Metzler- Poeschel Wiesbaden, Germany, 2000, Federal Statistical Office. Statistical Yearbook. Metzler- Poeschel Wiesbaden, Germany, 2004, Konakci KZ, Bohle B, Blumer R, et al. Alpha-gal on bioprostheses: xenograft immune response in cardiac surgery. Eur J Clin Invest. 2005;35: Volkert D, Kreuel K, Stehle P. Nutrition beyond 65-Amount of usual drinking fluid and motivation to drink are interrelated in community-living, independent elderly people. Z Gerontol Geriatr 2004;37: [in German]. INVITED COMMENTARY The authors [1] are to be commended for their careful study of a large cohort of predominantly elderly patients who underwent aortic valve replacement with a Mitroflow Synergy pericardial prosthesis (Sorin Group Inc, Mitroflow Division, Vancouver, Canada). They conclude that the bioprosthesis is a reliable choice, especially in patients older than 75 years of age with a small aortic annulus. Previously published reports suggest that structural valve deterioration of this prosthesis is problematic in valve sizes greater than 25 mm and among patients younger than 70 years of age. The present report moves the target population to those with a small annulus and age greater than 75 years. Scrutiny of the present data confirms high rates of structural valve deterioration among patients less than 75 years, but also suggests significant attrition of structural integrity at 5 years among patients between 75 and 84 years at the time of surgery. The ideal heart valve prosthesis may be the Holy Grail of heart valve surgery. We seek a prosthesis that has good hemodynamics, low rates of adverse events, and is durable. Is two out of three not bad? At present, with the availability of alternative heart valve prostheses that come increasing close to meeting all three criteria, it is difficult to imagine a rationale for the use a prosthesis that is known to deteriorate after only 5 years. David S. Bach, MD The University of Michigan L3119 Women s E Medical Center Dr Ann Arbor, MI dbach@umich.edu Reference 1. Minami K, Zitterman A, Schulte-Eistrup S, Koertke H, Körfer R. Mitroflow synergy prostheses for aortic valve replacement: 19 years experience with 1,516 patients. Ann Thorac Surg 2005;80: Dr Bach discloses a financial relationship with Edwards Lifesciences, Medtronic, and St. Jude Medical by The Society of Thoracic Surgeons /05/$30.00 Published by Elsevier Inc doi: /j.athoracsur
Department of Cardiothoracic Surgery, Heart and Lung Center, Lund University Hospital, Lund, Sweden
Long-Term Outcome of the Mitroflow Pericardial Bioprosthesis in the Elderly after Aortic Valve Replacement Johan Sjögren, Tomas Gudbjartsson, Lars I. Thulin Department of Cardiothoracic Surgery, Heart
More information16 YEAR RESULTS Carpentier-Edwards PERIMOUNT Mitral Pericardial Bioprosthesis, Model 6900
CLINICAL COMMUNIQUé 6 YEAR RESULTS Carpentier-Edwards PERIMOUNT Mitral Pericardial Bioprosthesis, Model 69 The Carpentier-Edwards PERIMOUNT Mitral Pericardial Valve, Model 69, was introduced into clinical
More informationCLINICAL COMMUNIQUE 16 YEAR RESULTS
CLINICAL COMMUNIQUE 6 YEAR RESULTS Carpentier-Edwards PERIMOUNT Mitral Pericardial Bioprosthesis, Model 6900 Introduction The Carpentier-Edwards PERIMOUNT Mitral Pericardial Valve, Model 6900, was introduced
More information15-Year Comparison of Supra-Annular Porcine and PERIMOUNT Aortic Bioprostheses
ORIGINAL CONTRIBUTION 15-Year Comparison of Supra-Annular Porcine and PERIMOUNT Aortic Bioprostheses WR Eric Jamieson, MD, Eva Germann, MSc, Michel R Aupart, MD 1, Paul H Neville, MD 1, Michel A Marchand,
More informationA 20-year experience of 1712 patients with the Biocor porcine bioprosthesis
Acquired Cardiovascular Disease Mykén and Bech-Hansen A 2-year experience of 1712 patients with the Biocor porcine bioprosthesis Pia S. U. Mykén, MD, PhD, a and Odd Bech-Hansen, MD, PhD b Objective: The
More informationCarpentier-Edwards Pericardial Valve in the Aortic Position: 25-Years Experience
SURGERY: The Annals of Thoracic Surgery CME Program is located online at http://www.annalsthoracicsurgery.org/cme/ home. To take the CME activity related to this article, you must have either an STS member
More informationReoperation for Bioprosthetic Mitral Structural Failure: Risk Assessment
Reoperation for Bioprosthetic Mitral Structural Failure: Risk Assessment W.R.E. Jamieson, MD; L.H. Burr, MD; R.T. Miyagishima, MD; M.T. Janusz, MD; G.J. Fradet, MD; S.V. Lichtenstein, MD; H. Ling, MD Background
More informationP have been used for mitral and aortic valve replacement
A -Year Comparison of Mitral Valve Replacement With Carpentier-Edwards and Hancock Porcine Bioprostheses P. Perier, MD, A. Deloche, MD, S. Chauvaud, MD, J. C. Chachques, MD, J. Relland, MD, J. N. Fabiani,
More informationThe St. Jude Medical Biocor Bioprosthesis
The St. Jude Medical Biocor Bioprosthesis Clinical Evidence of Long-term Durability Long-term Biocor Experience A Review and Comparative Assessment Long-term Biocor Stented Tissue Valve Studies Twenty-year
More informationClinical material and methods. Copyright by ICR Publishers 2003
Fourteen Years Experience with the CarboMedics Valve in Young Adults with Aortic Valve Disease Jan Aagaard 1, Jens Tingleff 2, Per V. Andersen 1, Christel N. Hansen 2 1 Department of Cardio-Thoracic and
More informationMedtronic Mosaic porcine bioprosthesis: Assessment of 12-year performance
Medtronic Mosaic porcine bioprosthesis: Assessment of 12-year performance W. R. Eric Jamieson, MD, a Friedrich-Christian Riess, MD, b Peter J. Raudkivi, MD, c Jacques Metras, MD, d Edward F. G. Busse,
More informationPrimary Tissue Valve Degeneration in Glutaraldehvde-Preserved Porcine Biomostheses: Hancock I Vekus Carpentier-Edwards at 4- to 7-Years Follow-up
Primary Tissue Valve Degeneration in Glutaraldehvde-Preserved Porcine Biomostheses: A Hancock I Vekus Edwards at 4- to 7-Years Follow-up Francisco Nistal, M.D., Edurne Artifiano, M.D., and Ignacio Gallo,
More informationPresenter Disclosure. Patrick O. Myers, M.D. No Relationships to Disclose
Presenter Disclosure Patrick O. Myers, M.D. No Relationships to Disclose Aortic Valve Repair by Cusp Extension for Rheumatic Aortic Insufficiency in Children Long term Results and Impact of Extension Material
More informationP substitutes since the introduction of the Ionescu-
Mitroflow Pericardial Valve: Long-Term Durability Daniel Y. Loisance, MD, Jean-Philippe Mazzucotelli, MD, Patrick C. Bertrand, MD, Philippe H. Deleuze, MD, and Jean-Paul Cachera, MD Department of Surgical
More informationSelf-Management of Oral Anticoagulation Therapy Improves Long-Term Survival in Patients With Mechanical Heart Valve Replacement
CARDIOVASCULAR ORIGINAL ARTICLES: CARDIOVASCULAR Self-Management of Oral Anticoagulation Therapy Improves Long-Term Survival in Patients With Mechanical Heart Valve Replacement Heinrich Koertke, MD, Armin
More informationSurgery for Acquired Cardiovascular Disease
Performance of bioprostheses and mechanical prostheses assessed by composites of valve-related complications to 15 years after mitral valve replacement W. R. E. Jamieson, MD, O. von Lipinski, MD, R. T.
More informationBioprostheses are prone to continuous degeneration
Twenty-Year Experience With the St. Jude Medical Biocor Bioprosthesis in the Aortic Position Walter B. Eichinger, MD, Ina M. Hettich, MD, Daniel J. Ruzicka, MD, Klaus Holper, MD, Carolin Schricker, Sabine
More informationT sors in the following aspects: the porcine aortic valve
Clinical and Hemodynamic Assessment of the Hancock I1 Bioprosthesis Tirone E. David, MD, Susan Armstrong, MSc, and Zhao Sun, MA Division of Cardiovascular Surgery, The Toronto Hospital and University of
More informationCarpentier-Edwards supra-annular aortic porcine bioprosthesis: Clinical performance over 20 years
Surgery for Acquired Cardiovascular Disease Carpentier-Edwards supra-annular aortic porcine bioprosthesis: Clinical performance over 20 years W. R. Eric Jamieson, MD, Lawrence H. Burr, MD, Robert T. Miyagishima,
More informationDurability of Pericardial Versus Porcine Aortic Valves
Journal of the American College of Cardiology Vol. 44, No. 2, 2004 2004 by the American College of Cardiology Foundation ISSN 0735-1097/04/$30.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2004.01.053
More informationTHE IMPACT OF AGE, CORONARY ARTERY DISEASE, AND CARDIAC COMORBIDITY ON LATE SURVIVAL AFTER BIOPROSTHETIC AORTIC VALVE REPLACEMENT
THE IMPACT OF AGE, CORONARY ARTERY DISEASE, AND CARDIAC COMORBIDITY ON LATE SURVIVAL AFTER BIOPROSTHETIC AORTIC VALVE REPLACEMENT Gideon Cohen, MD Tirone E. David, MD Joan Ivanov, MSc Sue Armstrong, MSc
More informationTAVR 2018: TAVR has high clinical efficacy according to baseline patient risk! ii. Con
TAVR 2018: TAVR has high clinical efficacy according to baseline patient risk! ii. Con Dimitrios C. Angouras, MD, FETCS Associate Professor of Cardiac Surgery National and Kapodistrian University of Athens,
More informationMitroflow Aortic Bioprosthesis 5-Year Follow-Up: North American Prospective Multicenter Study
Mitroflow Aortic Bioprosthesis 5-Year Follow-Up: North American Prospective Multicenter Study Federico M. Asch, MD, David Heimansohn, MD, Daniel Doyle, MD, Walter Dembitsky, MD, Francis D. Ferdinand, MD,
More informationThe operative mortality rate after redo valvular operations
Clinical Outcomes of Redo Valvular Operations: A 20-Year Experience Naoto Fukunaga, MD, Yukikatsu Okada, MD, Yasunobu Konishi, MD, Takashi Murashita, MD, Mitsuru Yuzaki, MD, Yu Shomura, MD, Hiroshi Fujiwara,
More informationHani K. Najm MD, Msc, FRCSC FACC, FESC President Saudi Society for Cardiac Surgeons Associate Professor of Cardiothoracic Surgery King Abdulaziz
Hani K. Najm MD, Msc, FRCSC FACC, FESC President Saudi Society for Cardiac Surgeons Associate Professor of Cardiothoracic Surgery King Abdulaziz Cardiac Centre Riyadh, Saudi Arabia Decision process for
More informationORIGINAL PAPER. The long-term results and changing patterns of biological valves at the mitral position in contemporary practice in Japan
Nagoya J. Med. Sci. 78. 369 ~ 376, 2016 doi:10.18999/nagjms.78.4.369 ORIGINAL PAPER The long-term results and changing patterns of biological valves at the mitral position in contemporary practice in Japan
More informationIntensity of oral anticoagulation after implantation of St. Jude Medical mitral or multiple valve replacement: lessons learned from GELIA (GELIA 5)
European Heart Journal Supplements () 3 (Supplement Q), Q39 Q43 Intensity of oral anticoagulation after implantation of St. Jude Medical mitral or multiple valve replacement: lessons learned from GELIA
More informationExpanding Relevance of Aortic Valve Repair Is Earlier Operation Indicated?
Expanding Relevance of Aortic Valve Repair Is Earlier Operation Indicated? RM Suri, V Sharma, JA Dearani, HM Burkhart, RC Daly, LD Joyce, HV Schaff Division of Cardiovascular Surgery, Mayo Clinic, Rochester,
More informationStandarized definition of bioprosthetic valve deterioration and failure
Translational aortic valve research. From biology to treatment Standarized definition of bioprosthetic valve deterioration and failure Anna Sonia Petronio, MD, FESC Head of Cardiac Catheterization Lab
More informationDurability and Outcome of Aortic Valve Replacement With Mitral Valve Repair Versus Double Valve Replacement
Durability and Outcome of Aortic Valve Replacement With Mitral Valve Repair Versus Double Valve Replacement Masaki Hamamoto, MD, Ko Bando, MD, Junjiro Kobayashi, MD, Toshihiko Satoh, MD, MPH, Yoshikado
More informationIndication, Timing, Assessment and Update on TAVI
Indication, Timing, Assessment and Update on TAVI Swedish Heart and Vascular Institute Ming Zhang MD PhD Interventional Cardiology Structure Heart Disease Conflict of Interest None Starr- Edwards Mechanical
More informationNineteen-Millimeter Aortic St. Jude Medical Heart Valve Prosthesis: Up to Sixteen Years Follow-up
Nineteen-Millimeter Aortic St. Jude Medical Heart Valve Prosthesis: Up to Sixteen Years Follow-up Dilip Sawant, FRCS, Arun K. Singh, MD, William C. Feng, MD, Arthur A. Bert, MD, and Fred Rotenberg, MD
More informationLate failure of transcatheter heart valves: An open question
Late failure of transcatheter heart valves: An open question A comparison with surgically implanted bioprosthetic heart valves. A. Rashid The Cardiothoracic Centre Liverpool, UK. Conflict of Interest Statement
More informationDoes Patient-Prosthesis Mismatch Affect Long-term Results after Mitral Valve Replacement?
Original Article Does Patient-Prosthesis Mismatch Affect Long-term Results after Mitral Valve Replacement? Hiroaki Sakamoto, MD, PhD, and Yasunori Watanabe, MD, PhD Background: Recently, some articles
More informationThe clinical experience reported in recent Western series has provided
Surgery for Acquired Cardiovascular Disease Yu et al Long-term evaluation of Carpentier-Edwards porcine bioprosthesis for rheumatic heart disease Hsi-Yu Yu, MD a Yi-Lwun Ho, MD b Shu-Hsun Chu, MD c Yih-Sharng
More informationExtension to medium and low risk patients? Friedrich Eckstein University Hospital Basel
TAVI CON Extension to medium and low risk patients? Friedrich Eckstein University Hospital Basel Extension to medium and low risk patients? In octogenerians already reality in most of the swiss clinics!?
More informationReconstruction of the intervalvular fibrous body during aortic and
Aortic and mitral valve replacement with reconstruction of the intervalvular fibrous body: An analysis of clinical outcomes Nilto C. De Oliveira, MD Tirone E. David, MD Susan Armstrong, MSc Joan Ivanov,
More informationPorcine bioprosthesis use for surgical treatment of
Fifteen-Year Clinical Experience With the Biocor Porcine Bioprostheses in the Mitral Position Kaan Kırali, MD, Mustafa Güler, MD, Altuğ Tuncer, MD, Bahadır Dağlar, MD, Gökhan İpek, MD, Ömer Işık, MD, and
More informationIncidence of prosthesis-patient mismatch in patients receiving mitral Biocor porcine prosthetic valves
INTERVENTION/VALVULAR HEART DISEASE ORIGINAL ARTICLE Cardiology Journal 2016, Vol. 23, No. 2, 178 183 DOI: 10.5603/CJ.a2016.0011 Copyright 2016 Via Medica ISSN 1897 5593 Incidence of prosthesis-patient
More informationClinical validation of a new drug seeking Food and
THE STATISTICIAN S PAGE Prosthetic Heart Valves: Objective Performance Criteria Versus Randomized Clinical Trial Gary L. Grunkemeier, PhD, Ruyun Jin, MD, and Albert Starr, MD Providence Health System,
More informationSimultaneous Aortic and Mitral Valve Replacement in Octogenarians: A Viable Option?
Simultaneous Aortic and Mitral Valve Replacement in Octogenarians: A Viable Option? Ariane Maleszka, MD,* Georg Kleikamp, MD, PhD,* Armin Zittermann, PhD, Maria R. G. Serrano, MD, and Reiner Koerfer, MD,
More informationCARPENTIER-EDWARDS PERICARDIAL VALVES IN THE MITRAL POSITION: TEN-YEAR FOLLOW-UP
CARPENTIER-EDWARDS PERICARDIAL VALVES IN THE MITRAL POSITION: TEN-YEAR FOLLOW-UP M. R. Aupart, MD P. H. Neville, MD S. Hammami, MD A. L. Sirineili, MD Y. A. Meurisse, MD M. A. Marchand, MD Objective: The
More informationAlthough numerous mechanical and biologic heart
International Normalized Ratio Self-Management After Mechanical Heart Valve Replacement: Is an Early Start Advantageous? Heinrich Körtke, MD, and Reiner Körfer, MD Department of Thoracic and Cardiovascular
More informationHani K. Najm MD, Msc, FRCSC, FRCS (Glasgow), FACC, FESC President of Saudi Heart Association King Abdulaziz Cardiac Centre Riyadh, Saudi Arabia.
Hani K. Najm MD, Msc, FRCSC, FRCS (Glasgow), FACC, FESC President of Saudi Heart Association King Abdulaziz Cardiac Centre Riyadh, Saudi Arabia. Decision process for Management of any valve Timing Feasibility
More informationOn October 3, 1977, the first St. Jude Medical (SJM)
The St. Jude Medical Cardiac Valve Prosthesis: A 25-Year Experience With Single Valve Replacement Robert W. Emery, MD, Christopher C. Krogh, Kit V. Arom, MD, PhD, Ann M. Emery, RN, Kathy Benyo-Albrecht,
More informationLong-Term Results With the Medtronic-Hall Valvular Prosthesis
Long-Term Results With the Medtronic-Hall Valvular Prosthesis Cary W. Akins, MD Cardiac Surgical Unit, Massachusetts General Hospital, Boston, Massachusetts Background. Although more than 170,000 Medtronic-
More informationLong-term results (22 years) of the Ross Operation a single institutional experience
Long-term results (22 years) of the Ross Operation a single institutional experience Authors: Costa FDA, Schnorr GM, Veloso M,Calixto A, Colatusso D, Balbi EM, Torres R, Ferreira ADA, Colatusso C Department
More informationA Surgeon s Perspective Guidelines for the Management of Patients with Valvular Heart Disease Adapted from the 2006 ACC/AHA Guideline Revision
A Surgeon s Perspective Guidelines for the Management of Patients with Valvular Heart Disease Adapted from the 2006 ACC/AHA Guideline Revision Prof. Pino Fundarò, MD Niguarda Hospital Milan, Italy Introduction
More informationBall Valve (Smeloff-Cutter) Aortic Valve Replacement Without Anticoagulation
Ball Valve (Smeloff-Cutter) Aortic Valve Replacement Without Anticoagulation Begonia Gometza, MD, and Carlos M. G. Duran, MD, PhD Department of Cardiovascular Diseases, King Faisal Specialist Hospital
More informationControversy exists regarding which valve type is best
Treatment of Endocarditis With Valve Replacement: The Question of Tissue Versus Mechanical Prosthesis Marc R. Moon, MD, D. Craig Miller, MD, Kathleen A. Moore, BS, Phillip E. Oyer, MD, PhD, R. Scott Mitchell,
More informationInfluence of patient gender on mortality after aortic valve replacement for aortic stenosis
Influence of patient gender on mortality after aortic valve replacement for aortic stenosis Jennifer Higgins, MD, W. R. Eric Jamieson, MD, Osama Benhameid, MD, Jian Ye, MD, Anson Cheung, MD, Peter Skarsgard,
More informationTwenty-year experience with the St Jude Medical mechanical valve prosthesis
Surgery for Acquired Cardiovascular Disease Ikonomidis et al Twenty-year experience with the St Jude Medical mechanical valve prosthesis John S. Ikonomidis, MD, PhD John M. Kratz, MD Arthur J. Crumbley
More informationManagement of Difficult Aortic Root, Old and New solutions
Management of Difficult Aortic Root, Old and New solutions Hani K. Najm MD, Msc, FRCSC,, FACC, FESC Chairman, Pediatric and Congenital Heart Surgery Cleveland Clinic Conflict of Interest None Difficult
More informationLong-term Experience with the Bjork-Shiley Monostrut Tilting Disc Valve
J Korean Med Sci 2007; 22: 1060-4 ISSN 1011-8934 DOI: 10.3346/jkms.2007.22.6.1060 Copyright The Korean Academy of Medical Sciences Long-term Experience with the Bjork-Shiley Monostrut Tilting Disc Valve
More informationAortic valve replacement with the Sorin Pericarbon Freedom stentless prosthesis: 7 years experience in 130 patients
Aortic valve replacement with the Sorin Pericarbon Freedom stentless prosthesis: 7 years experience in 130 patients Augusto D Onofrio, MD, Stefano Auriemma, MD, Paolo Magagna, MD, Alessandro Favaro, MD,
More informationMitral Valve Surgery: Lessons from New York State
Mitral Valve Surgery: Lessons from New York State Joanna Chikwe, MD Professor of Cardiovascular Surgery Icahn School of Medicine at Mount Sinai Chairman & Program Director Department of Cardiovascular
More informationEffect of Valve Suture Technique on Incidence of Paraprosthetic Regurgitation and 10-Year Survival
Effect of Valve Suture Technique on Incidence of Paraprosthetic Regurgitation and 10-Year Survival Sukumaran K. Nair, FRCS (C Th), Gauraang Bhatnagar, MBBS, Oswaldo Valencia, MD, and Venkatachalam Chandrasekaran,
More informationInterventional procedures guidance Published: 26 September 2014 nice.org.uk/guidance/ipg504
Transcatheter valve-in-valve e implantation for aortic bioprosthetic valve dysfunction Interventional procedures guidance Published: 26 September 2014 nice.org.uk/guidance/ipg504 Your responsibility This
More informationTAVR for Valve-In-Valve. Brian O Neill Assistant Professor of Medicine Department of Medicine, Section of Cardiology
TAVR for Valve-In-Valve Brian O Neill Assistant Professor of Medicine Department of Medicine, Section of Cardiology Temple Hearth and Vascular Institute Disclosures: Consultant: Cardiac Assist TAVR for
More informationPATIENT BOOKLET MEDTRONIC SURGICAL VALVE REPLACEMENT. Tissue Valve for Aortic and Mitral Valve Replacement
PATIENT BOOKLET MEDTRONIC SURGICAL VALVE REPLACEMENT Tissue Valve for Aortic and Mitral Valve Replacement ARE MEDTRONIC SURGICAL TISSUE HEART VALVES RIGHT FOR YOU? Medtronic surgical heart valves are for
More informationReoperations after primary aortic valve replacement
Third-Time Aortic Valve Replacement: Patient s and Operative Outcome Kasra Shaikhrezai, MD, MRCS, Giordano Tasca, MD, FETCS, Mohamed Amrani, PhD, FETCS, Gilles Dreyfus, MD, FETCS, and George Asimakopoulos,
More informationDepartment of Cardiac Surgery, Trousseau University Hospital, Tours, France
Risk Factors for Valve-Related Complications after Mechanical Heart Valve Replacement in 505 Patients with Long-Term Follow Up Thierry Bourguignon, Eric Bergöend, Alain Mirza, Grégoire Ayegnon, Paul Neville,
More informationW e have previously reported the results of a randomised
715 CARDIOVASCULAR MEDICINE Twenty year comparison of a mechanical heart valve with porcine bioprostheses H Oxenham, P Bloomfield, D J Wheatley, R J Lee, J Cunningham, R J Prescott, H C Miller... See end
More informationThe CarboMedics bileaflet prosthetic heart was introduced
The CarboMedics Valve: Experience With 1,049 Implants José M. Bernal, MD, José M. Rabasa, MD, Francisco Gutierrez-Garcia, MD, Carlos Morales, MD, J. Francisco Nistal, MD, and José M. Revuelta, MD Department
More informationTAVI- Is Stroke Risk the Achilles Heel of Percutaneous Aortic Valve Repair?
TAVI- Is Stroke Risk the Achilles Heel of Percutaneous Aortic Valve Repair? Elaine E. Tseng, MD and Marlene Grenon, MD Department of Surgery Divisions of Adult Cardiothoracic and Vascular and Endovascular
More informationRepair or Replacement
Surgical intervention post MitraClip Device: Repair or Replacement Saudi Heart Association, February 21-24 Rüdiger Lange, MD, PhD Nicolo Piazza, MD, FRCPC, FESC German Heart Center, Munich, Germany Division
More informationUpdate on Oral Anticoagulation for Mechanical Heart Valves
Update on Oral Anticoagulation for Mechanical Heart Valves Douglas C. Anderson, Pharm.D., D.Ph. Professor and Chair Dept. of Pharmacy Practice Cedarville University School of Pharmacy OHIO SOCIETY OF HEALTH-SYSTEM
More informationLong-Term Survival After Bovine Pericardial Versus Porcine Stented Bioprosthetic Aortic Valve Replacement: Does Valve Choice Matter?
Long-Term Survival After Bovine Pericardial Versus Stented Bioprosthetic Aortic Valve Replacement: Does Valve Choice Matter? Asvin M. Ganapathi, MD, Brian R. Englum, MD, Jeffrey E. Keenan, MD, Matthew
More informationPrognosis after aortic valve replacement with St. Jude Medical bileaflet prostheses: impact on outcome of varying thromboembolic and bleeding hazards
European Heart Journal Supplements (1) 3 (Supplement Q), Q27 Q32 Prognosis after aortic valve replacement with St. Jude Medical bileaflet prostheses: impact on outcome of varying thromboembolic and bleeding
More informationRead at the Twenty-fourth Annual Meeting of The Western Thoracic Surgical Association, Whistler, British Columbia, June 24-27, 1998.
STRUCTURAL VALVE DETERIORATION IN MITRAL REPLACEMENT SURGERY: COMPARISON OF CARPENTIER-EDWARDS SUPRA-ANNULAR PORCINE AND PERIMOUNT PERICARDIAL BIOPROSTHESES W. R. Eric Jamieson, MD a Michel A. Marchand,
More informationTSDA Boot Camp September 13-16, Introduction to Aortic Valve Surgery. George L. Hicks, Jr., MD
TSDA Boot Camp September 13-16, 2018 Introduction to Aortic Valve Surgery George L. Hicks, Jr., MD Aortic Valve Pathology and Treatment Valvular Aortic Stenosis in Adults Average Course (Post mortem data)
More informationVery Long-Term Survival Implications of Heart Valve Replacement With Tissue Versus Mechanical Prostheses in Adults <60 Years of Age
Very Long-Term Survival Implications of Heart Valve Replacement With Versus Prostheses in Adults
More informationThe Last Generation of Pericardial Valves in the Aortic Position: Ten-Year Follow-up in 589 Patients
The Last Generation of Pericardial Valves in the Aortic Position: Ten-Year Follow-up in 589 Patients Michel R. Aupart, MD, Agnes L. Sirinelli, MD, Frank F. Diemont, MD, Yvon A. Meurisse, MD, Xavier B.
More informationBicuspid aortic root spared during ascending aorta surgery: an update of long-term results
Short Communication Bicuspid aortic root spared during ascending aorta surgery: an update of long-term results Marco Russo, Guglielmo Saitto, Paolo Nardi, Fabio Bertoldo, Carlo Bassano, Antonio Scafuri,
More informationSpotlight on valvular heart disease guidelines. Prosthetic heart valves. Bernard Iung Bichat Hospital, Paris Diderot University Paris, France
Spotlight on valvular heart disease guidelines. Prosthetic heart valves. Bernard Iung Bichat Hospital, Paris Diderot University Paris, France Faculty disclosure First name - last name I disclose the following
More informationMechanical Tricuspid Valve Replacement Is Not Superior in Patients Younger Than 65 Years Who Need Long-Term Anticoagulation
Mechanical Tricuspid Valve Replacement Is Not Superior in Patients Younger Than 65 Years Who Need Long-Term Anticoagulation Ho Young Hwang, MD, PhD, Kyung-Hwan Kim, MD, PhD, Ki-Bong Kim, MD, PhD, and Hyuk
More informationThe St. Jude Medical mechanical valve is a low-profile,
Twenty-Five Year Experience With the St. Jude Medical Mechanical Valve Prosthesis J. Matthew Toole, MD, Martha R. Stroud, MS, John M. Kratz, MD, Arthur J. Crumbley III, MD, Scott M. Bradley, MD, Fred A.
More informationCoreValve in a Degenerative Surgical Valve
CoreValve in a Degenerative Surgical Valve Ran Kornowski, MD, FESC, FACC Chairman Department of Cardiology Rabin Medical Center, Petach Tikva, Israel Disclosure Statement of Financial Interest I, Ran Kornowski,
More informationEarly Experience of Transcatheter Mitral Valve Replacement Results from the Intrepid Global Pilot Study
Early Experience of Transcatheter Mitral Valve Replacement Results from the Paul Sorajja, MD for the Investigators Presenter Disclosure Information Within the past 12 months, I or my spouse/partner have
More informationA valve was initiated at the Medical University of
St. Jude Prosthesis for Aortic and Mitral Valve Replacement: A Ten-Year Experience John M. Kratz, MD, Fred A. Crawford, Jr, MD, Robert M. Sade, MD, Arthur J. Crumbley, MD, and Martha R. Stroud, MS Division
More information2017 Cardiovascular Symposium CARDIAC SURGERY UPDATE: SMALLER INCISIONS AND LESS COUMADIN DAVID L. SAINT, MD
2017 Cardiovascular Symposium CARDIAC SURGERY UPDATE: SMALLER INCISIONS AND LESS COUMADIN DAVID L. SAINT, MD David L Saint M.D. Tallahassee Memorial Hospital Southern Medical Group Division of Cardiothoracic
More informationEarly calcification of the aortic Mitroflow pericardial bioprosthesis in the elderly
doi:10.1510/icvts.2009.204958 Interactive CardioVascular and Thoracic Surgery 9 (2009) 842 846 www.icvts.org Negative results - Valves Early calcification of the aortic Mitroflow pericardial bioprosthesis
More informationLONG-TERM RESULTS OF HEART VALVE REPLACEMENT WITH THE EDWARDS DUROMEDICS BILEAFLET PROSTHESIS: A PROSPECTIVE TEN-YEAR CLINICAL FOLLOW-UP
LONG-TERM RESULTS OF HEART VALVE REPLACEMENT WITH THE EDWARDS DUROMEDICS BILEAFLET PROSTHESIS: A PROSPECTIVE TEN-YEAR CLINICAL FOLLOW-UP Bruno K. Podesser, MD a Gudrun Khuenl-Brady, MD a Ernst Eigenbauer,
More informationHeart valve replacement with the Bjork-Shiley and St Jude Medical prostheses: A randomized comparison in 178 patients
European Heart Journal (1990) 11, 583-591 Heart valve replacement with the Bjork-Shiley and St Jude Medical prostheses: A randomized comparison in 178 patients S. VOGT, A. HOFFMANN, J. ROTH, P. DUBACH,
More informationIschemic mitral valve reconstruction and replacement: Comparison of long-term survival and complications
Surgery for Acquired Cardiovascular Disease Ischemic mitral valve reconstruction and replacement: Comparison of long-term survival and complications Eugene A. Grossi, MD Judith D. Goldberg, ScD Angelo
More informationIsolated Mitral Valve Replacement with the Hancock Bioprosthesis: A 13-Year Appraisal
Isolated Mitral Valve Replacement with the Hancock ioprosthesis: A 13-Year Appraisal Vincenzo Gallucci, M.D., berto ortolotti, M.D., Aldo Milano, M.D., Carlo Valfrk, M.D., Alessandro Mazzucco, M.D., and
More informationPROVEN PLUS. Introducing the Avalus Aortic Valve by Medtronic.
PROVEN PLUS. Introducing the Avalus Aortic Valve by Medtronic. With more than 40 years of heart valve innovations, we took proven valve design concepts and adapted them for excellent implantability for
More informationAORTIC VALVE REPLACEMENT WITH FREEHAND AUTOLOGOUS PERICARDIUM
AORTIC VALVE REPLACEMENT WITH FREEHAND AUTOLOGOUS PERICARDIUM Fifty-one patients with a mean age of 31.2 years underwent aortic valve replacement with glutaraldehyde-treated autologous pericardium. Pure
More informationTAVR in patients with. End-Stage CKD or in Renal Replacement Therapy:
TAVR in patients with End-Stage CKD or in Renal Replacement Therapy: Special Considerations and Prevention of early Valve Failure Antonios Chalapas, MD, PhD, FESC THV & Hygeia Hospital Heart Team Athens,
More informationTAVR-Update Andrzej Boguszewski MD, FACC, FSCAI Vice Chairman, Cardiology Mid-Michigan Health Associate Professor Michigan State University, Central
TAVR-Update Andrzej Boguszewski MD, FACC, FSCAI Vice Chairman, Cardiology Mid-Michigan Health Associate Professor Michigan State University, Central Michigan University 1 Disclosure Chiesi Pharma- Consultant
More informationIncorporating the intermediate risk in Transcatheter Aortic Valve Implantation (TAVI)
Incorporating the intermediate risk in Transcatheter Aortic Valve Implantation (TAVI) Larry S. Dean, MD, MSCAI Past President SCAI Professor of Medicine and Surgery University of Washington School of Medicine
More informationChoice of Prosthetic Heart Valve in Adults
Journal of the American College of Cardiology Vol. 55, No. 22, 2010 2010 by the American College of Cardiology Foundation ISSN 0735-1097/$36.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2009.10.085
More informationI will not discuss off label use or investigational use in my presentation.
I will not discuss off label use or investigational use in my presentation. Surgical valves Design and Durability Testing Potential Concerns Real Practice 1952-1962 1963-1966 1967-1969 1969-1977 1977-1984
More information42yr Old Male with Severe AR Mild LV dysfunction s/p TOF -AV Replacement(tissue valve) or AoV plasty- Kyung-Hwan Kim
42yr Old Male with Severe AR Mild LV dysfunction s/p TOF -AV Replacement(tissue valve) or AoV plasty- Kyung-Hwan Kim Current Guideline for AR s/p TOF Surgery is reasonable in adults with prior repair of
More informationAortic valve replacement: is porcine or bovine valve better?
Interactive CardioVascular and Thoracic Surgery Advance Access published December 4, 2012 Interactive CardioVascular and Thoracic Surgery (2012) 1 13 doi:10.1093/icvts/ivs447 BEST EVIDENCE TOPIC Aortic
More informationExperience with 500 Stentless Aortic Valve Replacements
Experience with 500 Stentless Aortic Valve Replacements Dimitrios C. Iliopoulos, MD Cardiac Surgeon Ass. Professor of Surgery University of Athens, School of Medicine I declare no conflict of interest
More informationOutcomes of Mitral Valve Repair for Mitral Regurgitation Due to Degenerative Disease
Outcomes of Mitral Valve Repair for Mitral Regurgitation Due to Degenerative Disease TIRONE E. DAVID, MD ; SEMIN THORAC CARDIOVASC SURG 19:116-120c 2007 ELSEVIER INC. PRESENTED BY INTERN 許士盟 Mitral valve
More informationTissue vs Mechanical What s the Data??
Biological (Tissue) Valve in a 60 year old patient: Debate Tissue vs Mechanical What s the Data?? Joseph E. Bavaria, MD Immediate-Past President - Society of Thoracic Surgeons (STS) Brooke Roberts-William
More informationClinical event rates with the On-X bileaflet mechanical heart valve: A multicenter experience with follow-up to 12 years
Clinical event rates with the On-X bileaflet mechanical heart valve: A multicenter experience with follow-up to 12 years John B. Chambers, MD, FRCP, FACC, a Jose L. Pomar, MD, PhD, FETCS, b Carlos A. Mestres,
More informationMechanical vs. Bioprosthetic Aortic Valve Replacement: Time to Reconsider? Christian Shults, MD Cardiac Surgeon, Medstar Heart and Vascular Institute
Mechanical vs. Bioprosthetic Aortic Valve Replacement: Time to Reconsider? Christian Shults, MD Cardiac Surgeon, Medstar Heart and Vascular Institute Assistant Professor, Georgetown School of Medicine
More information