Twenty-seven patients 70 years of age or more were operated upon with aortic valvular replacement with an early mortality rate of 7%. No more patients died during a mean follow-up period of 28 months. The Björk-Shiley standard tilting disc valve was implanted in 15 cases and the new convexo-concave model in 12 cases. Sixty-seven per cent of the patients had narrow aortic roots (21 and 23 mm pro...

BACKGROUND Combined aortic valve repair and aortic valve-sparing surgery requires an approach determined by the leaflets and aortic root anatomy. METHODS Among patients referred for aortic root aneurysm, 114 patients underwent an aortic valve-sparing procedure in which a reimplantation or remodelling technique was used. The Gelweave Valsalva prosthesis (Sulzer Vascutek, Renfrewshire, UK) was ...

BACKGROUND The CarboMedics valve is a relatively new, low-profile, bileaflet, mechanical prosthesis. The results of a prospective follow-up study after valve replacement with this prosthesis in a university hospital are presented. METHODS We implanted 640 CarboMedics prostheses in 583 patients in the aortic (n = 359), mitral (n = 167), or aortic and mitral positions (double valve replacement;...

SINCE the introduction of artificial heart valves, investigators have been continuously modifying them, endeavoring to eliminate complications associated with their use. -3 The Starr-Edwards ball-valve prosthesis was the first to be widely accepted; however, problems due to its weight, cage size, and resistance to blood flow have stimulated the search for a better prosthetic device. In spite of...

BACKGROUND Transcatheter aortic valve implantation (TAVI) has proven to be a valid option for patients with severe aortic stenosis who are at high perioperative risk, particularly in patients with previous cardiac surgery. Several patients with previous mitral valve surgery were reported to have been successfully treated with TAVI. CASE PRESENTATION Two patients, one with mechanical and one w...

In this update, current guidelines addressing prosthesis selection published by the American College of Cardiology/American Heart Association (ACC/AHA) and the European Society of Cardiology (ESC) are discussed, along with additional data that affect choices in valve prostheses. The case of a 50-year-old man undergoing aortic valve replacement is used to address anticipated operative mortality,...

Anticoagulants are widely used for the prevention and treatment of venous and arterial thrombosis. The main indications for long-term anticoagulation therapy include treatment of venous thromboembolism (VTE), stroke prevention in atrial fibrillation (AF) and the prevention of valve thrombosis in patients with mechanical heart valves. For the past 65 years, vitamin K antagonists (VKA), such as w...

Objective: Doppler echocardiographic evaluation of prosthetic heart valve function is usually performed at rest although this situation is not representative of patients’ daily activities. Following aortic valve replacement, patients most likely to remain symptomatic are those with a small aortic root and dobutamine or exercise echocardiography has been proposed to elicit the presence of abnorm...

AIMS A comprehensive description of transcatheter heart valve (THV) failure has not been performed. We undertook a systematic review to investigate the aetiology, diagnosis, management, and outcomes of THV failure. METHODS AND RESULTS The systematic review was performed in accordance with the PRISMA guidelines using EMBASE, MEDLINE, and Scopus. Between December 2002 and March 2014, 70 publica...

Objective: To test the hypothesis that mitral valve prosthesis±patient mismatch increases postoperative mortality. Methods and results: The effect of mitral valve prosthesis±patient mismatch on survival in a cohort of consecutive patients after mitral valve replacement with a mechanical prosthesis was measured, focusing on the lower tail of the normal distribution curve of the prosthetic valve ...