Aortic valve replacement with the Hancock standard, Björk-Shiley, and Lillehei-Kaster prostheses
| Autor: | Uberto Bortolotti, Vincenzo Gallucci, Alessandro Mazzucco, Aldo Milano, Alberto Magni, Francisco Guerra |
|---|---|
| Rok vydání: | 1989 |
| Předmět: |
Pulmonary and Respiratory Medicine
Aortic valve medicine.medical_specialty business.industry medicine.medical_treatment Operative mortality Significant difference Tilting disc prosthesis Mean age medicine.disease Prosthesis Actuarial survival Surgery medicine.anatomical_structure Aortic valve replacement medicine Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Journal of Thoracic and Cardiovascular Surgery. 98:37-47 |
| ISSN: | 0022-5223 |
| DOI: | 10.1016/s0022-5223(19)34459-9 |
| Popis: | Three series of patients undergoing isolated aortic valve replacement with the standard glutaraldehyde-preserved Hancock porcine bioprosthesis, the standard Bjork-Shiley spherical disc prosthesis, and the Lillehei-Kaster tilting disc prosthesis were compared during a 15-year follow-up. From March 1970 to December 1985, aortic valve replacement was performed in 506 patients, 379 men and 109 women, whose ages ranged from 17 to 71 years (mean, 47 ± 12 years); 196 had a Hancock bioprosthesis, 147 a Bjork-Shiley prosthesis, and 163 a Lillehei-Kaster prosthesis. There were no significant differences among the three groups in terms of mean age, preoperative New York Heart Association class, valve lesion, associated intracardiac procedures, and operative mortality (11.7% for the Hancock bioprosthesis group, 8.8% for the Bjork-Shiley prosthesis group, and 9.2% for the Lillehei-Kaster prosthesis group). Cumulative duration of follow-up is 1140 patient-years (mean, 6.6 ± 1.5 years, 100% complete) for Hancock bioprosthesis patients, 878 patient-years (mean, 5.9 ± 0.4 years, 98% complete) for Bjork-Shiley prosthesis patients, and 1184 patient-years (mean, 7.3 ± 0.3 years, 97% complete) for Lillehei-Kaster prosthesis patients. Actuarial survival rates at 15 years are 30% ± 15% for Hancock bioprosthesis, 49% ±6% for Bjork-Shiley prosthesis, and 44% ±7% for Lillehei-Kaster prosthesis patients. There were eight embolic episodes in Hancock valve recipients (0.7% ± 0.1%/pt-yr), nine in Bjork-Shiley prosthesis recipients (1.0% ± 0.3% /pt-yr), and nine (0.7% ± 0.1% /pt-yr) in Lillehei-Kaster prosthesis recipients (p = no significant difference). Actuarial freedom from emboli at 15 years is 89% ±4% for Hancock, 92% ±3% for Bjork-Shiley, and 93% ±2% for Lillehei-Kaster prosthesis recipients (p = no significant difference). A significant difference was found in the incidence of the following complications. (1) Anticoagulant-related hemorrhage: 0.1% ± 0.1% /pt-yr for Hancock bioprosthesis, 1.3% ± 0.3% /pt-yr for Bjork-Shiley prosthesis, and 1.9% ± 0.4% /pt-yr for Lillehei-Kaster prosthesis patients (p |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|