title: Clinical results of the ATS prosthetic valve in 240 implants and review of the literature.
abstract: OBJECTIVE
  Despite having been used in many thousands of implants, few published data exist concerning the ATS valve. Clinical data from ATS valve implants are presented, and the first two cases of mitral valve thrombosis with the ATS valve reported. Published data are also reviewed comparatively.
  
  
  METHODS
  Between September 1998 and July 2000, 240 ATS valve prostheses were implanted in 199 patients, of whom 88 (36.6%) had mitral (MVR), 70 (29.1%) aortic (AVR), and 41 (17.1%) double valve replacements (DVR). Additional procedures were performed in 31 patients (15.6%). Transvalvular gradients and effective orifice areas were measured by transthoracic echocardiography. Total cumulative follow up of all patients was 241.6 patient-years (pt-yr); mean (+/-SE) follow up was 1.25+/-0.51 years.
  
  
  RESULTS
  There were six early deaths (3.0%). Overall and event-free survival rates during follow up were 98.96+/-0.73% and 97.90+/-1.22%, respectively. Anticoagulant-related hemorrhage occurred in one patient. The global incidence of hemorrhagic complications was 0.41 per 100 pt-yr. One patient with AVR was reoperated on for periprosthetic leakage in the first postoperative week. Valve thrombosis occurred in two patients with MVR at 12 and 14 months postoperatively. The incidence of valve thrombosis in MVR patients was 1.84 per 100 pt-yr (0.82 per 100 pt-yr overall). Hemolysis was seen only in one patient, echocardiographic examination revealing periprosthetic leakage.
  
  
  CONCLUSIONS
  The short-term outcome in 240 implants showed the ATS valve to be safe, to have a low incidence of complications, and to provide excellent hemodynamic performance.
authors.affiliation: Social Insurance Institute, Ankara Training Hospital, Department of Cardiovascular Surgery, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Ozeren
authors.forename: O V
authors.initials: OV
authors.lastname: DoGan
authors.forename: A
authors.initials: A
authors.lastname: Dolgun
authors.forename: E
authors.initials: E
authors.lastname: Koçyildirim
authors.forename: K
authors.initials: K
authors.lastname: Karapinar
authors.forename: E
authors.initials: E
authors.lastname: Yücel
authors.forename: E
authors.initials: E
authors.lastname: Koçyldirim
mesh_terms: D000293:Adolescent; D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D001021:Aortic Valve / Q000601:surgery; D004697:Endocarditis, Bacterial / Q000209:etiology / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000150:complications / Q000401:mortality / Q000628:therapy; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D006439:Hemodynamics / Q000502:physiology; D006470:Hemorrhage / Q000139:chemically induced / Q000401:mortality; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000401:mortality; D012086:Reoperation; D013203:Staphylococcal Infections / Q000209:etiology / Q000401:mortality; D013212:Staphylococcus epidermidis; D015996:Survival Rate; D013927:Thrombosis / Q000209:etiology / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology
chemical_list: D000925:Anticoagulants