Ten-Year Follow-up in Aortic Valve Replacement Using the Bjork-Shiley Prosthesis
|
|
- Corey Mills
- 6 years ago
- Views:
Transcription
1 Ten-Year Follow-up in Aortic Valve Replacement Using the Bjork-Shiley Prosthesis David Cheung, M.D., Robert J. Flemma, M.D., Donald C. Mullen, M.D., Denvard Lepley, Jr., M.D., Alfred J. Anderson, M.S., and Earl Weirauch, B.S. ABSTRACT An in-depth statistical analysis of early and late results of aortic valve replacement using the Bjork-Shiley tilting-disc prosthesis is presented. Our experience with this prosthesis indicates that replacement carries a low surgical risk, a low incidence of complications (embolization, infection, or hemorrhage due to long-term use of anticoagulants), and good long-term survival. Coexisting coronary artery disease increases surgical mortality significantly, and simultaneous, complete revascularization is essential. Patients un-.dergoing isolated aortic valve replacement did significantly better than those requiring other simultaneous procedures or those who had had previous operations. Earlier operation is imperative since progress of aortic valve disease is unpredictable by duration of symptoms, and patients in New York Heart Association Functional Class I1 have a low surgical risk and a greatly increased survival. It would appear from this study that additional criteria, such as increasing ventricular dilatation and hypertrophy determined by echocardiographic studies and gated nuclear studies showing deterioration of ejection fraction on exercise, should be used to help determine time of surgical intervention rather than symptomatology alone. Aortic valve replacement is now well established in the treatment of aortic valve disease [l, 21. However, there is still disagreement over the use of this approach for the asymptomatic or minimally symptomatic patient [31, and there is difficulty in assessing the risks to and longterm survival of patients undergoing valve replacement. Since the introduction of a valve From the Department of Thoracic and Cardiovascular Surgery, The Medical College of Wisconsin and St. Luke s Hospital, Milwaukee, WI. Presented at the Seventeenth Annual Meeting of The Society of Thoracic Surgeons, Jan 26-28,1981, Los Angeles, CA. Address reprint requests to Dr. Lepley, 9800 W Bluemound Rd, Milwaukee, WI prosthesis two decades ago, several different types of prosthesis have been developed, with frequent design modifications and numerous refinements in technique for valve replacement. Such developments have made the analysis of results of valve replacement more difficult, as numerous published papers have included data on prostheses of different types and models and changing surgical management. Since 1970, in Milwaukee, we have operated on approximately 1,500 patients for valve replacement in all positions using only the Bjork-Shiley tilting-disc prosthesis. Essentially the same method of surgical management and postoperative care were employed in all patients. No patient in the entire 10 years was refused operation based on severity of heart disease. This report, which summarizes the 10-year experience of aortic valve replacement, eliminates the yariables just mentioned and identifies more clearly surgical risk factors, incidence of complications, and long-term survival. Attention has been focused on the relationship between valve replacement combined with other procedures, and optimal time for operation. Material and Methods Between January 1, 1970, and December 31, 1979,579 patients underwent valve replacement in the aortic position. All patients who underwent associated procedures, who had had previous cardiac operation, or who fell into both categories were included. The mean follow-up was 48.8 months. Patients were divided into five groups according to the procedure performed (Table 1). In Group 1 were 280 patients who had isolated aortic valve replacement. Group 2 consisted of 92 patients who had aortic valve replacement and bypass operation. The 90 patients in Group 3 had both aortic and mitral valve replacement. In Group 4 were 109 patients who underwent aortic valve replacement as by The Society of Thoracic Surgeons
2 139 Cheung et al: Ten-Year Follow-up in Aortic Valve Replacement Table 1. Patient Profile of 579 Patients Based on Operation Performed Operative Group Procedure Done No. of Patients Mean Age (yr) Mortality (%)" Isolated AVR 280 AVR i- bypass 92 AVR + MVR 90 AVR f other 109 AVR i- AVR "Comparison of operative mortality between Group 1 and Groups 2, 3, 4, and 5 is significant (p < 0.001). AVR = aortic valve replacement; MVR = 'mitral valve replacement. well as other associated cardiac and great vessel procedures, such as resection of the aorta. Group 5 consisted of 8 patients who had had at least one previous operative procedure for aortic valve disease. The patients ranged from 38 to 76 years old (mean, 55 years). Those who had bypass operation were significantly older ( p < 0.01) than the other four groups (mean, 61 years) (see Table 1). Patients were also divided into subgroups based on the preoperative New York Heart Association (NYHA) Functional Class and the nature of the lesion of the aortic valve: aortic insufficiency (AI), aortic stenosis (AS), or mixed A1 + AS (Table 2). Surgical management of our patients has been described in detail previously [4]. A bubble oxygenator and a roller pump with moderate hypothermia (30 C) and hemodilution were used in all patients. Valves were inserted by means of interrupted mattress sutures with pledgets of Teflon felt as a buttress. Deep regional cardiac hypothermia, utilizing electrolyte solution at 4 C in the pericardium and intracavitary hypothermia of the left ventricle, was used for myocardial protection. Anticoagulation with intermittent, intravenous administration of heparin was carried out soon after removal of chest tubes (usually the day following operation), and Coumadin (sodium warfarin) was begun as soon as the patient could take liquids orally. The goal was a prothrombin time of 1% to 2 times normal. Heparin was administered for a full seven days, even though a therapeutic range of Coumadin might have been achieved earlier. Table 2. Patient Profile Based on Type of Lesion and New York Heart Association Functional Class No. of Mean Operative Variable Patients Age (vr) Mortalitv (Yo) PATHOPHYSIOLOGY AS A AS + A PREOPERATIVE FUNCTIONAL CLASS I a I sash IV asb Tomparison of operative mortality between Functional Class I1 and Classes 111 and IV is significant (p < 0.001). bcomparison of operative mortality between Functional Classes I11 and IV is significant (p < 0.002). AS = aortic stenosis; A1 = aortic insufficiency. Follow-up consisted of yearly office visits and a mail survey. Those who did not respond were reached by telephone or located through their cardiologist, family physician, or relatives. All data were computer analyzed. Only 4 patients were lost to follow-up or did not have sufficient data to be included, an overall follow-up of 99.3%. Results Sixty-six of the 579 patients did not survive the perioperative period (thirty days). Overall surgical mortality was 11.4% but ranged from 6.4% in Group 1 (isolated valve replacement) to 21.1% in Group 4 (replacement plus asso-
3 ~~ ~ 140 The Annals of Thoracic Surgery Vol 32 No 2 August 1981 Table 3. Causes of Mortality Among 579 Patients in 10-Year Study Cause Congestive heart failure Myocardial infarct Stroke Bleeding Cardiac arrest Infection Arrhythmia Low cardiac output Other heart-related Not heart-related Total 30 Day Late Total (11.4%) (16.8%) (28.2'Yo) c a A AV Only n AV+ *.,,,,. + A VS I P<0.02 ciated procedures) (see Table 1). No difference was found in the nature of the lesion, whether AS, AI, or mixed. Comparing Group 1 against the other groups in terms of operative mortality, a statistical difference is seen ( p < 0.001). Operative mortality for those in NYHA Functional Class I1 was considerably lower than for those in Classes I11 and IV [3.7% vs 12.8% and 27.1%, respectively ( p < O.OOl)] (see Table 2). Late mortality occurred in 97 patients or 16.8%. Table 3 lists the cause of death of these patients. Preoperatively, 19 were in Functional Class 11, 47 in Class 111, and 31 in Class IV. S u rv iv a 1 Although 7-year survival can be determined in this 10-year study, numbers at risk were small after the patients were divided into groups. Therefore, we elected to look at 5-year survival only. The overall 5-year survival was 70%. However, in those patients with isolated valve replacement, Group 1, 5-year survival was 73%. This figure is significantly higher than the 69% for those who had associated procedures ( p < 0.02) (Fig 1). The overall actuarial survival curve according to the type of procedure done also showed a significant difference between Group 1 and the other groups (p < 0.05). No difference in 5-year survival was observed when the groups were compared according to the nature of the lesion (A1 or AS) (Fig 2). However, the overall 5-year survival varied with preoperative NYHA Functional w In m o 1 i 3 i 5 6 i YEARS AS A Al x AStAI Fig 2. Comparison of 5-year survival based on the type of lesion. The difference in survival was not significant (NS). (AS = aortic stenosis; A1 = aortic insufficiency.) Class (Fig 3A); it was lower for those in Class IV, 36.6%, than for those in Class 111, 72.6%, or 11,85.1% ( p < 0.01 andp < 0.001, respectively). Similar results were seen in Group 1 (Fig 3B) and Groups 2, 3, 4, and 5 (Fig 3C). We analyzed the life-table survival curves of those who had symptoms for less than a year,
4 141 Cheung et al: Ten-Year Follow-up in Aortic Valve Replacement ! p s- b 40- a A VS X P<ooo1 x FC 3 A VS 0 p<o.001 ofc4 x vso p<ooi ImoI 2 3, 4 I YEARS A FC x FC I FC A c \-- 30 \ A FC2 AVt A vsx p<oo5 A x VS 0 P<o.Ol vs 0 p<ool ImoI YEARS A FC I x FC FC L 1 to 4 years, and 4 years or more. No significant difference was found in long-term survival (Fig 4). Functional Class Figure 5 shows the overall change in NYHA Functional Class from the preoperative to postoperative status of patients alive in Relatively few remained in Class I11 or IV ro -\ i/ ::::,, 20 x FC 3 A V S 0 P<oo Avs, x p, <0001, I m o I YEARS A FC , 19 X FC FC B Fig 3. (A) Overall survival based on preoperative New York Heart Association Functional Class. There was a significant difference between Functional Classes 11 (FC 2) and Ill (FC 3) compared with Class IV (FC 4). 03) Survival by preoperative Functional Class among patients having aortic valve replacement only. (C) Survival by preoperative Functional Class among patients having aortic valve replacement combined with other procedures (AV +). Overall, of those currently alive, 74% (303) have improved at least one NYHA Functional Class, 219'0 (86) remain the same, and only 5% (21) are reported to be worse. Tlie data for 6 patients are insufficient to include them. Complications HEMORRHAGE. In the postoperative period, 14 patients required exploration for hemorrhage, with infraxiphoid exploration in bed or return to the operating room and reopening of the sternum. Late tamponade was encountered in 8 patients. THROMBOEMBOLISM. Twenty-eight patients sustained 36 embolisms (Table 4). Six patients were not taking anticoagulants at the time of the incident. One of them refused to take medication regularly and died of a massive cerebral embolus 22 months after operation. At postmortem examination, the valve prosthesis was covered partly by clot (fresh and organized) and
5 142 The Annals of Thoracic Surgery Vol 32 No 2 August ' ' g A Symptoms <I yr p = NS x Symptoms I-4yrs Symptoms >4 yrs ' I,,,, I I I Table 4. Incidence of Thromboembolic Episodes in 10-Year Follow-up of 513 Patients Episode NOT FATAL Cerebrovascular accident Without residuals 9 With residuals 7 Clotted valve surgically repaired 1 Peripheral embolus 2 Renal embolus 1 Coronary embolus 1 Total 21a FATAL No. of Embolisms Better 303 Same 86 Ome 2/ huff dato Cerebrovascular accident 11 Clotted valve 3 Myocardial infarction 1 Total 15. aoverall: 1.2 episodes per 100 patient-years. hematuria, and a week later a saddle embolus developed. The patient recovered fully after embolectomy. In another patient a peripheral arterial embolus developed after he stopped taking the anticoagulant because of a postoper- % of ative sternal infection. The sixth patient sus- Patients tained a cerebral embolism 14 months after operation but recovered partially. Emboli developed in-3 additional patients despite their being on a therapeutic dose of anticoagulant. One of them had a successful operation on the clotted valve 2 years after the initial operation. Thromboembolic complications resulted in 15 deaths. Among those whose complication was not fatal, 9 patients had no residual effects. ALL CLASS CLASS CLASS Excluding patients who were not on a regi- CLASSES II. IlI Ip men of anticoagulants, there were 28 emboli per PRE-OPERATIVE CLASS 23,095 patient-months or 1.2 emboli per 100 Fig 5. Preoperative to postoperative change in New York Heart Association Functional Class at late patient-years. This compares favorably with follow-utl. other reported series [5, 61. All episodes were carefully traced. ANTICOAGULATION. Hemorrhage due to anthere were numerous infarcts in the heart and ticoagulant therapy during the 10-year study kidneys from embolization. Three of the pa- resulted in 5 deaths from subdural subtients had the anticoagulants stopped on ac- arachnoid and cerebral hemorrhage. Location count of bleeding. In 2 of them, gastrointestinal of severe but not fatal hemorrhage was as folhemorrhage clotted the prosthesis and they lows: nose, 2; renal, 3; gastrointestinal, 6; redied of congestive heart failure. The third had spiratory, 1; musculoskeletal, 4; and eye, 2.
6 143 Cheung et al: Ten-Year Follow-up in Aortic Valve Replacement Apart from the 2 patients who had partial loss of vision from retinal hemorrhage, the remaining patients experienced no residual effects. The overall incidence of hemorrhage from anticoagulation is 1.2 per 100 patient-years. VALVE MALFUNCTION. Four out of 579 patients were known to have thrombotic obstruction of the prosthesis. Only 1 was operated on successfully. In the remaining 3 patients, the malfunction was not recognized and was found only at postmortem examination. Paraprosthetic leak occurred in 3 patients in the entire series. Only two of the leaks were sufficiently severe to require surgical correction. All followed bacterial endocarditis. One of the 2 patients requiring reoperation lived; the other died after a third replacement. INFECTION. Sixteen patients (2.8%) had bacterial endocarditis: 5, early and 11, late. Four of the 5 patients seen early had endocarditis of the aortic valve prior to replacement. Five underwent emergency valve replacement; 3 of these patients lived. The other 11 patients were treated medically; 6 of them died and 5 survived, although 1 had a mild paraprosthetic leak. Total mortality from infection was 1.4% (0.14% per year). The most common organism was Staphylococcus epidermidis, and most patients sought medical treatment late. Infection developed in 1 patient, a drug addict, when antibiotic cover was omitted after a dental operation and in another patient, an alcoholic, when antibiotic cover was not provided after cholecystectomy. The survivors were seen early and either underwent operation despite infection and hemodynamic failure or had reoperation after the infection was controlled or treated with a long-term course of antibiotics. Comments Valve Replacement and Bypass Operation Coronary atherosclerosis is a frequent finding in adults with aortic valve disease but its coexistence cannot be accurately predicted on the basis of presence of angina [7]. In our series, preoperative coronary arteriography was carried out in each of the 579 patients. Angina was present in 60% of patients who underwent aortic valve replacement only and had normal coronary vessels, while it was absent in 25% of patients who had simultaneous bypass operation. We agree with Jacob and colleagues [8] that preoperative coronary arteriography should be carried out routinely, especially in the adult patient with valvular heart disease. Aortic valve replacement combined with bypass operation in this study carried a significantly higher mortality than isolated valve replacement (p < 0.01). Such a discrepancy from the results of other series prompted us to analyze our data more closely. The decision to combine bypass operation with aortic valve replacement was made in the presence of a critical, obstructive lesion (> 70% stenosis) in a coronary artery. In our practice, during a combined procedure, lesions between 40 and 50% obstructed were often simultaneously revascularized. On examining these moderate, obstructive lesions in our analysis, we found that they influenced the operative mortality. In Group 1, the presence of such a lesion increased the operative mortality from 2.5 to 6% if not bypassed, although the difference was not statistically significant. In Group 2, patients in NYHA Functional Class I1 also showed no significant difference in operative mortality between those with and without bypass of the moderately stenotic arteries; however, in patients in NYHA Functional Class IV, operative mortality dropped from 22 to 9% when 40 to 50% stenotic lesions were also bypassed (p < 0.3). It would appear that moderately stenotic lesions in the presence of critical lesions should also be corrected when patients with aortic valve disease are in NYHA Functional Class IV. Timing of Operation Following aortic valve replacement, the majority of patients improved, as shown in our series and others [5, 6, 9, 101, irrespective of the preoperative NYHA Functional Class. Yet, the significantly higher operative mortality and shorter survival time in patients in Functional Class IV or I11 compared with those in Functional Class I1 suggest that early operation is desirable. The left ventricle in aortic valve disease compensates in the early stage of the disease for pressure or volume overload or both by hypertrophy and dilatation. The degree of compensation and the length of time before decompen-
7 144 The Annals of Thoracic Surgery Vol 32 No 2 August 1981 Table 5. Probability of Surviving 5 Years following Aortic Valve Replacement Alone or Combined with Other Procedures according to Regression Analysis of the Three Most Important Risk Factors 40 AVR AVR AVR AVR AVR AVR N = 579 Age FC t = 3.77; p < t = 7.83; p < N = 579 Age AVR, AVR+ FC t = 3.81; p < t = 1.96; p < 0.05 t = 7.39; p < AVR AVR AVR AVR AVR AVR N = 299 Age FC t = 2.48; p < 0.02 t = 5.14; p < N = 280 Age FC aoperative procedure is not under consideration in this section of table. t = 2.93; p < 0.01 t = 5.76; p < NYHA = New York Heart Association; AVR = aortic valve replacement; AVR+ = aortic valve replacement plus other procedures; FC = Functional Class. sation resulting in irreversible myocardial damage are variable and unpredictable. In this study, there was no significant difference in long-term survival in patients with symptoms of different duration (see Fig 4). Thus, the duration of symptoms cannot be used to predict when a patient will move from Functional Class I1 to IV. At the present time, reliable and durable valve prostheses, low surgical risk (surgical mortality in patients with only valve disease was less than 2o/d), and minimal complications appear to justify the recommendation of earlier valve replacement in minimally symptomatic patients. Table 5 was constructed using Cox regression analysis [ll] of the three risk factors-age, Functional Class, and operative procedurefound to be significant in predicting 5-year survival in patients who have had aortic valve replacement. We again note that Functional Class is highly significant in determining long-term survival. References 1. Barnhorst DA, Oxman HA, Connolly DC, et al: Isolated replacement of the aortic valve with the Starr-Edwards prosthesis: a 9-year review. J Thorac Cardiovasc Surg 70:113, Lee SJK, Barr C, Callaghan JC, et al: Long-term survival after aortic valve replacement using the Smeloff-Cutter prosthesis. Circulation 52:1132, Rahimtoola ST: Early valve replacement for preservation of ventricular function. Am J Cardiol 40:472, Lepley D Jr, Reuben CF, Flemma RJ, et al: Experience with the Bjork-Shiley prosthetic valve. Circulation 47:Suppl 3:51, Bjork VO, Henze A: Results five to seven years after aortic valve replacement with the original Delrin disc model Bjork-Shiley prosthesis. Scand J Thorac Cardiovasc Surg 11:177, 1977
8 145 Cheung et al: Ten-Year Follow-up in Aortic Valve Replacement 6. Copeland JG, Griepp RB, Stinson EB, Shumway NE: Long-term follow-up after isolated aortic valve replacement. J Thorac Cardiovasc Surg 74:875, Bonchek LI, Anderson RP, Rosch J: Should coronary arteriography be performed routinely before valve replacement? Am J Cardiol 31:462, Jacobs ML, Fowler BN, Vezeridis MP, et al: Aortic valve replacement: a 9-year experience. Ann Thorac Surg 30:439, Barnhorst DA, Oxman HA, Connolly DC, et al: Long-term survival follow-up of isolated replacement of aortic and mitral valve with the Starr-Edwards prosthesis. Am J Cardiol 35:228, Roberts DL, DeWeese JA, Maloney EB, Yu PN: Long-term survival following aortic valve replacement. Am Heart J 91:311, Cox DR: Regression models and life tables. J R Statis SOC Series B 34:187, 1972 Discussion DR. VIKING 0. BJORK (Stockholm, Sweden): In their paper the authors gave reference only to my early Delrin-disc valve, which has functioned excellently as shown by 10-year follow-up aortography. They do not state whether they use the pyrolytic carbon, or the standard convexo-concave discs. Today, with 260,000 Bjork-Shiley valves implanted, 2,500 in the Karolinska in Stockholm, some follow-up is available. The authors had a 99.3% follow-up, which is excellent, but their 10-year follow-up averages 4 years. This reminds me of a comment by a Texas friend who said that in his state they can do a 5-year follow-up in just a little more than a year. Of the 125 patients I operated on 10 years ago or more, 65% are living today. That is actual survival and is, as you remember, 10% more than the value reported by Albert Starr. The oldest is 75 years old. I seldom comment on the mortality rate reported by others, but the authors did not analyze whether the mortality decreased in recent years, as it has in my material from 5.8 to 3.8%. Among their patients having double-valve replacement, aortic and mitral, the mortality was 12% compared with my 8%. My question is whether in the longer operation, their myocardial preservation technique using cold fluid in the pericardium and inside the heart with thick myocardium is as effective as cardioplegia with oxygenated blood given every twenty minutes. The incidence of paravalvular leak-3 of 579 patients-compares favorably with my 2.4%. I learned from their manuscript that mattress sutures with pledgets are much better than the single overand-over suture, which, of course, in a very narrow aortic root, permits a larger prosthesis. The functional investigation using the New York Heart Association Classes is not as objective as transseptal catheterization measuring how the stroke volume at rest increases during an exercise test-before operation and after operation-and how it compares with that of normal 60-year-old patients. I think that test is more objective. The convexo-concave disc now available has a better hemodynamic response with a shorter closing time and less regurgitation. There is a 4-year follow-up survival of 91% including operative mortality in the aortic position, a nonfatal thromboembolic complication rate of 1.4 per 100 patient-years, and no valve thrombosis. In 1980, we implanted 100 valves with an opening angle of 70 degrees. I am convinced that the valve should not open more than 70 degrees, unlike the St. Jude valve. The latter has a 0.5 mm lower gradient in the smaller aortic valves, but has a much higher pulsative regurgitation in both the aortic and mitral positions. I congratulate Dr. Cheung and his co-authors on a careful and valuable analysis of risk factors when other procedures are added to aortic valve replacement with the Bjork-Shiley valve. DR. CHEUNG: Thank you, Dr. Bjork, for your kind comments and for sharing your series. In regard to myocardial protection in patients having double-valve replacement, perhaps the cardioplegic method is safer, but in our series most of these patients were in Functional Classes I11 and IV. The high mortality is probably related to the fact that these patients have a poor left ventricle. Perhaps our mortality could be improved if we used the cold cardioplegic way of protecting the heart. Our low incidence of thromboembolism is probably related to the fact that we routinely anticoagulate our patients with heparin, usually twenty-four hours after operation, and start orally administered Coumadin at the same time. The heparin is continued for a full course of seven days even though the patients are given a therapeutic dose of Coumadin. We believe that the thrombus is formed in the early stages, and Coumadin alone could not prevent it.
and Coronary Artery Surgery George M. Callard, M.D., John B. Flege, Jr., M.D., and Joseph C. Todd, M.D.
Combined Valvular and Coronary Artery Surgery George M. Callard, M.D., John B. Flege, Jr., M.D., and Joseph C. Todd, M.D. ABSTRACT Between July, 97, and March, 975,45 patients underwent combined valvular
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 informationSmeloff-Cutter Prosthesis: 1- to 12-Year Follow-up David S. Starr, M.D., Gerald M. Lawrie, M.D., J. F. Howell, M.D., and George C. Morris, Jr., M.D.
Clinical Experience with the Smeloff-Cutter Prosthesis: 1- to 12-Year Follow-up David S. Starr, M.D., Gerald M. Lawrie, M.D., J. F. Howell, M.D., and George C. Morris, Jr., M.D. ABSTRACT To determine the
More information164 Ann Thorac Surg 45: , Feb Copyright by The Society of Thoracic Surgeons
Heart Valve Replacement with the Bjork-Shiley Mbnostrut Valve: Early Results of a Multicenter Clinical Investigation Lars I. Thulin, M.D., William H. Bain, F.R.C.S., Hans H. Huysmans, M.D., Gerrit van
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 informationAspirin or Coumadin as the Drug of Choice
Aspirin or Coumadin as the Drug of Choice for Valve Replacement with Porcine Bioprosthesis L. Nufiez, M.D., M. Gil Aguado, M.D., D. Celemin, M.D., A. Iglesias, M.D., and J. L. Larrea, M.D. ABSTRACT Eight
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 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 informationValve Disease in Patients With Heart Failure TAVI or Surgery? Miguel Sousa Uva Hospital Cruz Vermelha Lisbon, Portugal
Valve Disease in Patients With Heart Failure TAVI or Surgery? Miguel Sousa Uva Hospital Cruz Vermelha Lisbon, Portugal I have nothing to disclose. Wide Spectrum Stable vs Decompensated NYHA II IV? Ejection
More informationClinical Evaluation of the Lillehei-Kaster Pivoting-Disc Valve
Clinical Evaluation of the Lillehei-Kaster Pivoting-Disc Valve Peter J. K. Starek, M.D., Lambert P. McLaurin, M.D., Benson R. Wilcox, M.D., and Gordon F. Murray, M.D. ABSTRACT A four-year clinical evaluation
More informationOpen-Heart Surgery in Patients More than 65 Years Old
Open-Heart Surgery in Patients More than 65 Years Old Donald A. Barnhorst, M.D., Emilio R. Giuliani, M.D., James R. Pluth, M.D., Gordon K. Danielson, M.D., Robert B. Wallace, M.D., and Dwight C. McGoon,
More informationThe Ross Procedure: Outcomes at 20 Years
The Ross Procedure: Outcomes at 20 Years Tirone David Carolyn David Anna Woo Cedric Manlhiot University of Toronto Conflict of Interest None The Ross Procedure 1990 to 2004 212 patients: 66% 34% Mean age:
More informationResults of Mitral Valve Replacement, with Special Reference to the Functional Tricuspid Insufficiency
Results of Mitral Valve Replacement, with Special Reference to the Functional Tricuspid Insufficiency Ken-ichi ASANO, M.D., Masahiko WASHIO, M.D., and Shoji EGUCHI, M.D. SUMMARY (1) Surgical results of
More informationin Patients Having Aortic Valve Replacement John T. Santinga, M.D., Marvin M. Kirsh, M.D., Jairus D. Flora, Jr., Ph.D., and James F. Brymer, M.D.
Factors Relating to Late Sudden Death in Patients Having Aortic Valve Replacement John T. Santinga, M.D., Marvin M. Kirsh, M.D., Jairus D. Flora, Jr., Ph.D., and James F. Brymer, M.D. ABSTRACT The preoperative
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 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 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 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 informationAortic and Mitral Valve Incompetence: Long-Term Follow-Up (10 to 19 Years) of Patients Treated With the Starr-Edwards Prosthesis
93 lacc Vol. 3. No.4 April 19H4:93-8 Aortic and Mitral Valve Incompetence: Long-Term Follow-Up (1 to 19 ) of Patients Treated With the Starr-Edwards Prosthesis MICHAEL D. McGOON, MD, VALENTIN FUSTER, MD,
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 informationRight-Sided Bacterial Endocarditis
New Concepts in the Treatment of the Uncontrollable Infection Agustin Arbulu, M.D., Ali Kafi, M.D., Norman W. Thorns, M.D., and Robert F. Wilson, M.D. ABSTRACT Our experience with 25 patients with right-sided
More informationMitral Valve Redacernent with the Modified Univekity of Cape Town (UCT) Prosthesis: Clinical and Hernodynamic Results
Mitral Valve Redacernent with the Modified Univekity of Cape Town (UCT) Prosthesis: Clinical and Hernodynamic Results F. Henry Ellis, Jr., M.D., Ph.D., Robert W. Healy, M.D., and Sidney Alexander, M.D.
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 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 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 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 informationLate Stenosis of Starr-Edwards Cloth-Covered Prostheses
Late Stenosis of Starr-Edwards Cloth-Covered Prostheses Walter Smithwick, 111, M.D., Nicholas T. Kouchoukos, M.D., Robert B. Karp, M.D., Albert D. Pacifico, M.D., and John W. Kirklin, M.D. ABSTRACT During
More informationThe Bjork-Shiley Prosthesis
The Bjork-Shiley Prosthesis A Significant Advance in Aortic Valve Replacement Javier Fernandez, M.D., Vladir Maranhao, M.D., Alden S. Gooch, M.D., Dryden Morse, M.D., and Henry T. Nichols, M.D." ABSTRACT
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 informationAortic Valve Practice Guidelines: What Has Changed and What You Need to Know
Aortic Valve Practice Guidelines: What Has Changed and What You Need to Know James F. Burke, MD Program Director Cardiovascular Disease Fellowship Lankenau Medical Center Disclosure Dr. Burke has no conflicts
More informationRisks of Mitral Valve Replacement and
Risks of Mitral Valve Replacement and Mitral Valve Replacement with Coronary Artery Bypass James A. Magovern, M.D., John L. Pennock, M.D., David B. Campbell, M.D., William S. Pierce, M.D., and John A.
More informationUniversity of Florida Department of Surgery. CardioThoracic Surgery VA Learning Objectives
University of Florida Department of Surgery CardioThoracic Surgery VA Learning Objectives This service performs coronary revascularization, valve replacement and lung cancer resections. There are 2 faculty
More informationCase. 15-year-old boy with bicuspid AV Severe AR with moderate AS. Ross vs. AVR (or AVP)
Case 15-year-old boy with bicuspid AV Severe AR with moderate AS Ross vs. AVR (or AVP) AMC case 14-year-old boy with bicuspid AV Severe AS with mild AR Body size Bwt: 55 kg, Ht: 154 cm, BSA: 1.53 m 2 Echocardiography
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 informationMechanical Bleeding Complications During Heart Surgery
Mechanical Bleeding Complications During Heart Surgery Arthur C. Beall, Jr., M.D., Kenneth L. Mattox, M.D., Mary Martin, R.N., C.C.P., Bonnie Cromack, C.C.P., and Gary Cornelius, C.C.P. * Potential for
More informationMinimally Invasive Aortic Surgery With Emphasis On Technical Aspects, Extracorporeal Circulation Management And Cardioplegic Techniques
Minimally Invasive Aortic Surgery With Emphasis On Technical Aspects, Extracorporeal Circulation Management And Cardioplegic Techniques Konstadinos A Plestis, MD System Chief of Cardiothoracic and Vascular
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 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 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 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 informationCoronary Atherosclerosis in Valvular Heart Disease
Coronary Atherosclerosis in Valvular Heart Disease Jerome Lacy, M.D., Robert Goodin, M.D., Daniel McMartin, M.D., Ronald Masden, M.D., and Nancy Flowers, M.D. ABSTRACT To evaluate the usefulness of routine
More information";g. and Determinants of Risk. or 1,000 Patients, ery: Perioperative Mortality. Reoperations for Valve S
Reoperations for Valve S and Determinants of Risk ";g ery: Perioperative Mortality or, Patients, 98-984 Bruce W. Lytle, M.D., Delos M. Cosgrove, M.D., Paul C. Taylor, M.D., Carl C. Gill, M.D., Marlene
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 informationManagement of Fusiform Ascending Aortic Aneurysms
Management of Fusiform Ascending Aortic Aneurysms Stuart Houser, M.D., Jose Mijangos, M.D., Amarenda Sengupta, M.D., Lawrence Zaroff, M.D., Robert Weiner, M.D., and James A. DeWeese, M.D. ABSTRACT Thirteen
More informationDepartment 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 informationThe risk-benefit ratio of mitral valve operation is
Degenerative Mitral Regurgitation: When Should We Operate? Malcolm J. R. Dalrymple-Hay, PhD, Mark Bryant, Richard A. Jones, MRCP, Stephen M. Langley, FRCS, Steven A. Livesey, FRCS, and James L. Monro,
More informationTSDA ACGME Milestones
TSDA ACGME Milestones Short MW and Edwards JA. Assessing resident milestones using a CASPE March 2012 Short MW and Edwards JA. Assessing resident milestones using a CASPE March 2012 Short
More informationThe Medtronic-Hall Cardiac Valve:
The Medtronic-Hall Cardiac Valve: 7?h Years' Clinical Experience Regent L. Beaudet, M.D., Normand L. Poirier, M.D., Daniel Doyle, M.D., Gisde Nakhlb, M.Sc., and Christiane Gauvin, M.T. ABSTRACT Clinical
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 informationAustralia and New Zealand Source Registry Edwards Sapien Aortic Valve 30 day Outcomes
Australia and New Zealand Source Registry Edwards Sapien Aortic Valve 30 day Outcomes A/ Professor Darren Walters On behalf of the ANZ Source Investigators Director of Cardiology Brisbane, Australia ANZ
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 informationAutologous Pulmonary Valve Replacement of the Diseased Aortic Valve
Autologous Pulmonary Valve Replacement of the Diseased Aortic Valve By L. GONZALEZ-LAvIN, M.D., M. GEENS. M.D., J. SOMERVILLE, M.D., M.R.C.P., ANm D. N. Ross, M.B., CH.B., F.R.C.S. SUMMARY Living tissue
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 informationSpotlight on Valvular Heart Disease Guidelines
Spotlight on Valvular Heart Disease Guidelines Aortic Valve Disease Raphael Rosenhek Department of Cardiology Medical University of Vienna Palermo, April 26 th 2018 1998 2002 2006 2007 2008 2012 2014 2017
More informationSurgical AVR: Are there any contraindications? Pyowon Park Samsung Medical Center Seoul, Korea
Surgical AVR: Are there any contraindications? Pyowon Park Samsung Medical Center Seoul, Korea Contents Decision making in surgical AVR in old age Clinical results of AVR with tissue valve Impact of 19mm
More informationIntroduction. Study Design. Background. Operative Procedure-I
Risk Factors for Mortality After the Norwood Procedure Using Right Ventricle to Pulmonary Artery Shunt Ann Thorac Surg 2009;87:178 86 86 Addressor: R1 胡祐寧 2009/3/4 AM7:30 SICU 討論室 Introduction Hypoplastic
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 informationSupplementary Appendix
Supplementary Appendix This appendix has been provided by the authors to give readers additional information about their work. Supplement to: Kang D-H, Kim Y-J, Kim S-H, et al. Early surgery versus conventional
More informationLeft Ventricular Wall Resection for Aneurysm and Akinesia due to Coronary Artery Disease: Fifty Consecutive Patients
Left Ventricular Wall Resection for Aneurysm and Akinesia due to Coronary Artery Disease: Fifty Consecutive Patients Armand A. Lefemine, M.D., Rajagopalan Govindarajan, M.D., K. Ramaswamy, M.D., Harrison
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 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 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 informationAortic Valve Replacement with Starr-Edwards Valves over 14 Years
Aortic Valve Replacement with Starr-Edwards Valves over 4 Years W. H. Wain, B.Sc., Ph.D., P. J. Drury, B.Sc., Ph.D., andd. N. Ross, F.R.C.S. ABSTRACT Three hundred thirteen patients underwent aortic valve
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 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 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 informationEjection across stenotic aortic valve requires a systolic pressure gradient between the LV and aorta. This places a pressure load on the LV.
Valvular Heart Disease General Principles Etiology Cellular and molecular mechanism of valve damage Structural pathology Functional pathology - stenosis/regurgitation Loading conditions - pressure/volume
More informationIntra-operative Echocardiography: When to Go Back on Pump
Intra-operative Echocardiography: When to Go Back on Pump GREGORIO G. ROGELIO, MD., F.P.C.C. OUTLINE A. Indications for Intraoperative Echocardiography B. Role of Intraoperative Echocardiography C. Criteria
More informationHeart Valves: Before and after surgery
Heart Valves: Before and after surgery Tim Sutton, Consultant Cardiologist Middlemore Hospital, Auckland Auckland Heart Group Indications for intervention in Valvular disease To prevent sudden death and
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 informationProf. Patrizio LANCELLOTTI, MD, PhD Heart Valve Clinic, University of Liège, CHU Sart Tilman, Liège, BELGIUM
The Patient with Aortic Stenosis and Mitral Regurgitation Prof. Patrizio LANCELLOTTI, MD, PhD Heart Valve Clinic, University of Liège, CHU Sart Tilman, Liège, BELGIUM Aortic Stenosis + Mitral Regurgitation?
More informationEjection across stenotic aortic valve requires a systolic pressure gradient between the LV and aorta. This places a pressure load on the LV.
Valvular Heart Disease Etiology General Principles Cellular and molecular mechanism of valve damage Structural pathology Functional pathology - stenosis/regurgitation Loading conditions - pressure/volume
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 informationManagement during Reoperation of Aortocoronary Saphenous Vein Grafts with Minimal Atherosclerosis by Angiography
Management during Reoperation of ortocoronary Saphenous Vein Grafts with therosclerosis by ngiography William G. Marshall, Jr., M.D., Jeffrey Saffitz, M.D., and Nicholas T. Kouchoukos, M.D. STRCT The proper
More informationAdult Cardiac Surgery
Adult Cardiac Surgery Mahmoud ABU-ABEELEH Associate Professor Department of Surgery Division of Cardiothoracic Surgery School of Medicine University Of Jordan Adult Cardiac Surgery: Ischemic Heart Disease
More informationCardiac anaesthesia. Simon May
Cardiac anaesthesia Simon May Contents Cardiac: Principles of peri-operative management for cardiac surgery Cardiopulmonary bypass, cardioplegia and off pump cardiac surgery Cardiac disease and its implications
More informationFocused. se with 2008 F. lar Heart Diseas. date. ents With Valvul. Upd. gement of Patie. lines for Manag. HA 2006 Guidel ACC/AH. Fig.
ACC/AH HA 2006 Guidel nic severe AI (Fig. 4). ned by age, ay also be helpful nd echo. For AI, ollow up may be or MRI rather than mension; SD, end lines for Manag gement of Patie Upd ents With Valvul date
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 informationCIPG Transcatheter Aortic Valve Replacement- When Is Less, More?
CIPG 2013 Transcatheter Aortic Valve Replacement- When Is Less, More? James D. Rossen, M.D. Professor of Medicine and Neurosurgery Director, Cardiac Catheterization Laboratory and Interventional Cardiology
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 informationHeart Valve Replacement
Heart Valve Replacement Introduction Sometimes people have serious problems with the valves in their hearts. A heart valve repair or replacement surgery restores or replaces a defective heart valve. If
More informationIdiopathic Hypertrophic Subaortic Stenosis and Mitral Stenosis
CASE REPORTS Idiopathic Hypertrophic Subaortic Stenosis and Mitral Stenosis Martin J. Nathan, M.D., Roman W. DeSanctis, M.D., Mortimer J. Buckley, M.D., Charles A. Sanders, M.D., and W. Gerald Austen,
More informationIndications of Coronary Angiography Dr. Shaheer K. George, M.D Faculty of Medicine, Mansoura University 2014
Indications of Coronary Angiography Dr. Shaheer K. George, M.D Faculty of Medicine, Mansoura University 2014 Indications for cardiac catheterization Before a decision to perform an invasive procedure such
More informationKinsing Ko, Thom de Kroon, Najim Kaoui, Bart van Putte, Nabil Saouti. St. Antonius Hospital, Nieuwegein, The Netherlands
Minimal Invasive Mitral Valve Surgery After Previous Sternotomy Without Aortic Clamping: Short- and Long Term Results of a Single Surgeon Single Institution Kinsing Ko, Thom de Kroon, Najim Kaoui, Bart
More informationEchocardiographic Evaluation of Aortic Valve Prosthesis
Echocardiographic Evaluation of Aortic Valve Prosthesis Amr E Abbas, MD, FACC, FASE, FSCAI, FSVM, RPVI Co-Director, Echocardiography, Director, Interventional Cardiology Research, Beaumont Health System
More informationValve Disease. Valve Surgery. Total Volume. In 2016, Cleveland Clinic surgeons performed 3039 valve surgeries.
Valve Surgery Total Volume 1 1 Volume 35 3 5 15 1 5 1 13 1 N = 773 5 79 15 93 1 339 In 1, surgeons performed 339 valve surgeries. surgeons have implanted more than 1, bioprosthetic aortic valves since
More informationProfessor and Chief, Division of Cardiac Surgery Chief Medical Officer, Harpoon Medical. The Houston Aortic Symposium February 23-25, 2017
James S. Gammie, MD Professor and Chief, Division of Cardiac Surgery Chief Medical Officer, Harpoon Medical The Houston Aortic Symposium February 2-25, 2017 Disclosure Statement of Financial Interest Within
More informationThe CarboMedics prosthetic valve (Sulzer CarboMedics,
Long-Term Result of 1144 CarboMedics Mechanical Valve Implantations Chang Hyun Kang, MD, Hyuk Ahn, MD, Kyung Hwan Kim, MD, and Ki-Bong Kim, MD Department of Thoracic and Cardiovascular Surgery, Seoul National
More informationAscending Aortic Associated Aortic. Aneurysms with Regurgitation. Koger K. Stenlund, M.D., Charles K. Peterson, M.D.
Ascending Aortic Associated Aortic Aneurysms with Regurgitation Hovald K. Helseth, M.D., John J. Haglin, M.D., Koger K. Stenlund, M.D., Charles K. Peterson, M.D., and David W. Gauger, M.D. ABSTRACT A safe
More informationLate Results after Correction of Ventricular Septal Defect with Severe Pulmonary Hypertension
Tohoku J. Exp. Med., 1994, 174, 41-48 Late Results after Correction of Ventricular Septal Defect with Severe Pulmonary Hypertension KIYOSHI HANEDA, NAOSHI SATO, TAKAO TOGO, MAKOTO MIURA, MASAKI RATA and
More informationBiological or mechanical valve prosthesis?
XXIX Giornate Cardiologiche Torinesi ADVANCES IN CARDIAC ARRHYTHMIAS AND GREAT INNOVATIONS IN CARDIOLOGY Turin, October 27-28, 2017 Centro Congressi Unione Industriale WHAT HAS CHANGED IN CARDIAC SURGERY?
More informationThe diameter of the aortic valve is in direct proportion
The CarboMedics Top-Hat Supraannular Prosthesis José M. Bernal, MD, Rafael Martin-Duran, MD, José M. Rabasa, MD, and José M. Revuelta, MD Departments of Cardiovascular Surgery and Echocardiography, Hospital
More informationIndex of subjects. effect on ventricular tachycardia 30 treatment with 101, 116 boosterpump 80 Brockenbrough phenomenon 55, 125
145 Index of subjects A accessory pathways 3 amiodarone 4, 5, 6, 23, 30, 97, 102 angina pectoris 4, 24, 1l0, 137, 139, 140 angulation, of cavity 73, 74 aorta aortic flow velocity 2 aortic insufficiency
More informationPATIENT BOOKLET MEDTRONIC MITRAL AND TRICUSPID HEART VALVE REPAIR
PATIENT BOOKLET MEDTRONIC MITRAL AND TRICUSPID HEART VALVE REPAIR ARE MEDTRONIC HEART VALVE REPAIR THERAPIES RIGHT FOR YOU? Prosthetic (artificial) heart valve repair products are used by physicians to
More informationery: Comparison of Predicted and Observed Resu ts
Preoperative Risk Assessment in Cardiac Sur K ery: Comparison of Predicted and Observed Resu ts Forrest L. Junod, M.D., Bradley J. Harlan, M.D., Janie Payne, R.N., Edward A. Smeloff, M.D., George E. Miller,
More informationEchocardiographic Evaluation of Mitral Valve Prostheses
Echocardiographic Evaluation of Mitral Valve Prostheses Dennis A. Tighe, M.D., FACC, FACP, FASE Cardiovascular Medicine University of Massachusetts Medical School Worcester, MA www.asecho.org 1 Nishimura
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 informationThe St. Jude Valve Prosthesis: Analysis of the Clinical Results in 815 Implants and the Need for Systemic Anticoagulation
JACC Vol. 13. No. I 57 Jxuary IYX9:57-h? The St. Jude Valve Prosthesis: Analysis of the Clinical Results in 815 Implants and the Need for Systemic Anticoagulation MARY LEE MYERS, MD, FACC, GERALD M. LAWRIE,
More information(Ann Thorac Surg 2008;85:845 53)
I Made Adi Parmana The utility of intraoperative TEE has become increasingly more evident as anesthesiologists, cardiologists, and surgeons continue to appreciate its potential application as an invaluable
More informationThe Ins and Outs of Cardiac Surgery. Stephanie Wold RN MN NP
The Ins and Outs of Cardiac Surgery Stephanie Wold RN MN NP 1 The Ins and Outs of Cardiac Surgery Cardiac Surgery in a Nutshell 2 Outline Wait Times and Referral Process for Cardiac Surgery Getting Ready
More information