[Malfunction of prosthetic valves: pathogenesis and diagnostic measure].
Modality of the malfunction of prosthetic valve often reflects the specific features of its design and materials of the prosthesis. During past 17 years, a total of 499 cases of valve replacements were performed in our institute and among them, 50 cases received redo surgery, in which 52 prosthetic valves were replaced due to their malfunctions. Those replaced prosthetic valves were analyzed in terms of their pathogenesis, onset durations and diagnostic methods of each type of malfunction. The malfunctions included hemolytic anemia, thrombosis or tissue overgrowth and tissue failure of bioprostheses. Hemolytic anemia was experienced in 8 cases with Starr-Edwards (S-E) 2320 (n = 7) and Omni-Science (n = 1) both in the aortic position and those prostheses were replaced at 1-9.6 (mean 4.5) postoperative years (POY). The linearized rate of the complication with the S-E 2320 was 3.0%/patient-years (p-y) and its actuarial event free rate was 62% at 11 POY. Operative findings disclosed cloth wear in 5 and perivalvular leakage in 5 cases. Fourteen Hancock (H) and 3 Angell-Shiley (A-S) bioprostheses experienced tissue failure of valves and they were subjected to reoperation at 3.2-10.0 (mean 6.5) POY. The linearized rates were 4.1%/p-y for H and 4.5%/p-y for A-S with actuarial event free rates at 12 POY of 59 and 56%, respectively. Prosthetic valve thrombosis and/or tissue overgrowth were seen in 17 valves at 1.6-15.1 (mean 9.1) POY.(ABSTRACT TRUNCATED AT 250 WORDS)
Sato
N
N
Department of Thoracic and Cardiovascular Surgery, Tohoku University School of Medicine.
Ito
T
T
Miura
M
M
Sekino
Y
Y
Ohmi
M
M
Tabayashi
K
K
Haneda
K
K
Mohri
H
H
Nitta
S
S
D000293:Adolescent; D000328:Adult; D001021:Aortic Valve; D001705:Bioprosthesis; D002648:Child; D005260:Female; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve; D011475:Prosthesis Failure; D014261:Tricuspid Valve