OBJECTIVE To develop an easy-to-use tool for decision-making on prophylactic replacement of Björk-Shiley convexo-concave heart valves. DESIGN Decision analysis comparing elective replacement with observation. SETTING Referral centres for patients with artificial heart valves. PATIENTS Quantitative estimates were obtained from a follow up study conducted in The Netherlands, including 2303 ...

A case of aortic valve replacement with a Björk-Shiley disc prosthesis in a patient with sickle-cell trait is presented. Six months after operation red cell survival was not significantly reduced. On theoretical and clinical grounds it is concluded that the presence of sickle-cell trait does not contribute to late postoperative haemolysis after heart valve replacement.

The requirement of varying doses of warfarin for different individuals can be explained by environmental and genetic factors. We evaluated the frequency of vitamin K epoxide reductase complex subunit 1 (VKORC1) and cytochrome P450 2C9 (CYP2C9) variants together with patientdemographic characteristics and investigated their association with warfarin dose requirement with the ob...

Global myocardial ischemia and ischemia-reperfusion injury are potential adverse events related with cardioplegic arrest. Beating heart surgery has avoided such complications and adapted to valve surgery following successful results published on myocardial revascularization. Difficulty in weaning from cardiopulmonary bypass may be lessened by using on-pump beating heart surgery for mitral valve...

BACKGROUND We performed the first quadruple valve replacement with mechanical valves, combined with the correction of complex congenital heart disease on November 17, 1999. We report here the 11-year follow-up study. METHODS A 47-year-old man with subacute rheumatic endocarditis, a ventricular septal defect, and an obstruction of the right ventricular outflow tract required replacement of the...

The tissue-engineered heart valve portends a new era in the field of valve replacement. Decellularized heart valves are of great interest as a scaffold for the tissue-engineered heart valve due to their naturally bioactive composition, clinical relevance as a stand-alone implant, and partial recellularization in vivo. However, a significant challenge remains in realizing the tissue-engineered h...

Conventional replacement therapies for heart valve disease are associated with significant drawbacks. The field of tissue engineering has emerged as an exciting alternative in the search for improved heart valve replacement structures. One of the principles behind this concept is the transplantation of living elements, embedded in a suitable scaffold material, to the diseased site where the str...

BACKGROUND Because of risk of outlet strut fracture, prophylactic replacement should be considered for Björk-Shiley convexo-concave (BScc) valve recipients. We assessed the effects of epidemiological and decision-analytic guidelines on actual BScc valve replacement. METHODS AND RESULTS We performed a retrospective cohort study including all 2263 Dutch BScc patients with a mean follow-up of 11...

Twenty-eight patients who underwent aortic valve replacement and coronary artery bypass grafts (group A) were compared, with respect to clinical presentation, operative mortality and morbidity and follow-up clinical status, with 40 patients who had normal coronary arteriograms and underwent aortic valve replacement only (group B). Groups A and B had a similar incidence of angina pectoris, cardi...

s of the studies obtained were screened for those that examined outcomes following aortic valve replacement. References in these reports were cross checked for other relevant studies. This resulted in 76 published reports for mechanical valves and 68 for bioprostheses. The following criteria for each valve type were then stipulated in order to obtain homogeneous groups of studies: N Valves 19–3...