[Analysis of surgical treatment of 220 patients with acquired left aortic valve defect].
The results of surgical treatment of 220 patients with acquired aortic valve malformations using two different methods were evaluated 5 years postoperatively. In 130 patients the aortic valve was replaced with "fresh" allograft and in the remaining 90 with prosthetic valve. In the group with allograft compared to patients after prosthetic valve implantation we have found: lower early mortality of 3% (p less than or equal to 0.01) (vs. 15.5%) higher probability of 5 years survival of 91.5% (p less than or equal to 0.001) (vs. 74.6%) low incidence of thromboembolic events of 1.7% (p less than or equal to 0.05) (vs. 8.8%) Allografts appear to be especially advisable and well tolerated in patients with active endocarditis. No statistically significant difference was found between both groups in relation to: probability of late death (5 years postoperatively), frequency of bacterial endocarditis during the postoperative course, frequency of valve failure. Slow increase of degenerative alterations during the succeeding postoperative years was distinctive for allografts, and the dysfunction of the implants appeared from the third postoperative year with the risk of 1.5% to 0.8% annually. Dysfunction of the prosthetic valve (perivalvular leak, thrombosis) was observed with the frequency of 5% to 1.3% annually. It developed quickly and usually was the cause of an urgent operation. The study demonstrates the advantages of allografts and their superiority over the prosthetic valves. Allograft implantation produces better life comfort for patients and diminishes or excludes the risk of thromboembolic complications.
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Kliniki Chirurgii Serca i Naczyń Instytutu Kardiologii AM, Krakowie.
D000293:Adolescent; D000328:Adult; D001021:Aortic Valve / Q000637:transplantation*; D001022:Aortic Valve Insufficiency / Q000401:mortality / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000601:surgery*; D001705:Bioprosthesis / Q000592:standards*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects / Q000592:standards*; D002102:Cadaver; D006327:Heart Block / Q000209:etiology*; D006801:Humans; D008875:Middle Aged; D011044:Poland; D011183:Postoperative Complications / Q000209:etiology*; D013927:Thrombosis / Q000209:etiology*; D014184:Transplantation, Homologous
Analiza leczenia chirurgicznego 220 chorych z nabyta wada lewego ujścia tetniczego.