[Mid-term results of heart valve replacement with 2 types of pericardial heterograft. Apropos of 208 cases].
Medium-term results of valve replacement with a pericardial bioprosthesis were analysed in 141 patients receiving an Ionescu-Shiley aortic prosthesis and in 67 patients receiving a Mitroflow aortic (42), mitral (21) or double mitro-aortic (4) bioprostheses. There were 8 deaths in the operative (5.7%) and medium term (56 months) follow-up periods in the Ionescu group and a cumulative survival of 625 patient-years. There were 16 late deaths, 8 of cardiac origin. The 8 year survival and good functional results rates were 71% and 53% respectively. The linear rates of thrombo-embolism, endocarditis, reoperation, valvular dysfunction and regurgitation were 3.5, 1.1, 2.6, 2.7 and 6.1% patient-years. The corresponding figures in the Mitroflow bioprostheses were 0.5, 1.0, 3.1, 3.1 and 5.6% patient-years, but the average follow-up was shorter (36 months) with a cumulative survival of 195 patient-years. These results underline the frequency of primary valve dysfunction the mechanisms of which are: early tear in areas of high mechanical stress and late calcification. However, the hemodynamic profiles of this type of prosthesis are better than those of porcine bioprostheses which make them a valuable alternative in elderly patients operated for calcific aortic stenosis with a small aortic ring.
Michel
P L
PL
Service de cardiologie, hôpital Tenon, Paris.
Vahanian
A
A
Porte
J M
JM
Plotton
C
C
Labedan
F
F
Dewilde
J
J
Acar
J
J
D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D001021:Aortic Valve; D001705:Bioprosthesis; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000637:transplantation*; D011475:Prosthesis Failure; D012086:Reoperation; D015996:Survival Rate; D013927:Thrombosis / Q000209:etiology
Résultats à moyen terme du remplacement valvulaire à l'aide de deux types d'hétérogreffes péricardiques. A propos de 208 patients.