Clinical evaluation of the Björk-Shiley disc valve in the tricuspid position Long-term results
| Autor: | Spyt Tj, Bain Wh, NA Weerasena, Pye M |
|---|---|
| Rok vydání: | 1990 |
| Předmět: |
Adult
Male Reoperation Pulmonary and Respiratory Medicine medicine.medical_specialty Adolescent medicine.medical_treatment Doppler echocardiography Prosthesis Internal medicine medicine Humans Endocarditis cardiovascular diseases Child Tricuspid valve medicine.diagnostic_test business.industry General Medicine Long term results Middle Aged Bleed Prognosis medicine.disease Echocardiography Doppler Surgery medicine.anatomical_structure Heart Valve Prosthesis cardiovascular system Cardiology Female Tricuspid Valve Cardiology and Cardiovascular Medicine Complication business Clinical evaluation Follow-Up Studies |
| Zdroj: | European Journal of Cardio-Thoracic Surgery. 4:19-23 |
| ISSN: | 1010-7940 |
| DOI: | 10.1016/1010-7940(90)90235-r |
| Popis: | Between 1971 and 1981, 1210 Björk-Shiley prostheses were implanted. Of these, 79 were in the tricuspid position, comprising 30 triple valve replacements, 46 mitral plus tricuspid, and 3 isolated tricuspid replacements. The ages ranged from 10-55 years (mean 45 years). Sixty-three patients (80%) were in NYHA grades III or IV preoperatively. Thirteen patients died in hospital after surgery (16.5%). The 66 survivors have been followed for up to 16 years (mean 7.5 years). There have been 37 late deaths (7.5 per patient year). Twelve were valve-related: 4 tricuspid complications, 4 mitral complications, 2 prosthetic endocarditis, 1 aortic leak and 1 anticoagulant-related bleed. Twenty-one late deaths were not valve-related, and 4 causes of death are unknown. Expressed actuarially, survival at 5 years was 68%, and at 10 years, 49.4% +/- 12%. Freedom from valve-related death at 10 years was 80.7% +/- 7%. At last follow-up, 90% of the survivors were in NYHA class 1 or 2 with only modest signs of venous hypertension. The commonest life-threatening complication was obstruction of the tricuspid prosthesis by tissue ingrowth. This occurred in 7 patients (1.4% per patient year) 4 were re-operated upon and survived, 3 died. Doppler echocardiography has been carried out on 27 survivors of whom 5 had abnormal pressure-half times but only 3 of these were symptomatic. This series shows that function of the standard disc Björk-Shiley prosthesis in the tricuspid position compares favourably with other prostheses. The problem of tissue ingrowth can be diagnosed by echo Doppler and reoperation successfully carried out. |
| Databáze: | OpenAIRE |
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