We analyzed the intermediate experience, survival, and prosthetic complications of patients who received the Biocor valve, a new-generation porcine valve, in the mitral position. At the University of Padua, between Ma...We analyzed the intermediate experience, survival, and prosthetic complications of patients who received the Biocor valve, a new-generation porcine valve, in the mitral position. At the University of Padua, between May 1992 and January 2004, 154 consecutive patients(102 female and 52 male patients; mean age, 72.3±6 years; age range, 37-86 years) received 158 mitral Biocor prostheses(Biocor Industria e Pesguisa Ltda, Belo Horizonte, Brazil). Thirty-five percent of the patients had previous mitral operations, 24%had coronary artery bypass grafting, and 34.6%had other procedures. Median preoperative New York Heart Association class was III. Echocardiography was performed in 75%of the long-term survivors. Follow-up included 609.4 patient-years and was 100%complete, with a median time of 4 patient-years(range, 0.02-11.3 years). At 8 years, 20(14%) of 142 operative survivors were still at risk. Early mortality was 13.6%. According to univariate analysis, New York Heart Association class III to IV, ejection fraction of less than 40%, urgency, male sex, and coronary artery bypass grafting were significant perioperative risk factors. Eight-and 10-year actuarial survival was 51.1%±5.6%(40 deaths). Eight-year actuarial freedom from valve-related death, thromboembolism, anticoagulant-related hemorrhage, endocarditis, paravalvular leak, and valve-related complications were 85.2%±5%, 85.7%±4.4%, 92.6%±3.7%, 94.1%±3%, 91.8%±3%, and 70.2%±5.7%, respectively. Freedom from structural valve deterioration was 100%. Actual freedom from reoperation was 93.2%±2.2%. By Doppler echocardiography, the peak and mean transprosthetic gradients were 15±5 mm Hg and 6.3±3 mm Hg, respectively(mean follow-up, 4.2±2.7 years). At intermediate follow-up, the Biocor prosthesis in the mitral position showed excellent results in terms of valve durability when compared with other second-generation tissue valves.展开更多
We have used artificial chordal replacement with expanded polytetrafluoroethylene sutures for mitral valve repair in children and reported favorable early clinical results. In this article we evaluate the midterm resu...We have used artificial chordal replacement with expanded polytetrafluoroethylene sutures for mitral valve repair in children and reported favorable early clinical results. In this article we evaluate the midterm results of mitral valve repair with expanded polytetrafluoroethylene sutures in 39 children. From April 1995 through September 2003, mitral valve repair with chordal replacement using expanded polytetrafluoroethylene sutures was performed in 39 patients. In all patients the preoperative grade of mitral regurgitation was moderate or more because of prolapse of the anterior mitral leaflet. The mean age and body weight at the time of the operation were 4.7±5.3 years(range, 1 month to 17.8 years) and 14.4±12.2 kg(range, 3.9-54.4 kg), respectively. The number of expanded polytetrafluoroethylene sutures ranged from 1 to 3(mean, 1.4). The mean follow-up period and body weight at the latest follow-up were 5.0±2.3 years(range, 1.1-8.5 years) and 25.7±16.4 kg(range, 6.9-73 kg), respectively. There were no operative or late deaths. Only one patient required mitral valve replacement, which occurred 17 days after repair. Two patients underwent redo mitral valve repair 2 and 5 years after initial repair, respectively. The actuarial freedom from reoperation at 5 and 8 years was 94.8%and 89.5%, respectively. At the latest follow-up, trivial or less mitral regurgitation was observed in 33(84.6%) patients. Mitral valve repair with expanded polytetrafluoroethylene sutures in children demonstrated favorable midterm outcome. The procedure is safe and effective,with potential for patients’growth.展开更多
文摘We analyzed the intermediate experience, survival, and prosthetic complications of patients who received the Biocor valve, a new-generation porcine valve, in the mitral position. At the University of Padua, between May 1992 and January 2004, 154 consecutive patients(102 female and 52 male patients; mean age, 72.3±6 years; age range, 37-86 years) received 158 mitral Biocor prostheses(Biocor Industria e Pesguisa Ltda, Belo Horizonte, Brazil). Thirty-five percent of the patients had previous mitral operations, 24%had coronary artery bypass grafting, and 34.6%had other procedures. Median preoperative New York Heart Association class was III. Echocardiography was performed in 75%of the long-term survivors. Follow-up included 609.4 patient-years and was 100%complete, with a median time of 4 patient-years(range, 0.02-11.3 years). At 8 years, 20(14%) of 142 operative survivors were still at risk. Early mortality was 13.6%. According to univariate analysis, New York Heart Association class III to IV, ejection fraction of less than 40%, urgency, male sex, and coronary artery bypass grafting were significant perioperative risk factors. Eight-and 10-year actuarial survival was 51.1%±5.6%(40 deaths). Eight-year actuarial freedom from valve-related death, thromboembolism, anticoagulant-related hemorrhage, endocarditis, paravalvular leak, and valve-related complications were 85.2%±5%, 85.7%±4.4%, 92.6%±3.7%, 94.1%±3%, 91.8%±3%, and 70.2%±5.7%, respectively. Freedom from structural valve deterioration was 100%. Actual freedom from reoperation was 93.2%±2.2%. By Doppler echocardiography, the peak and mean transprosthetic gradients were 15±5 mm Hg and 6.3±3 mm Hg, respectively(mean follow-up, 4.2±2.7 years). At intermediate follow-up, the Biocor prosthesis in the mitral position showed excellent results in terms of valve durability when compared with other second-generation tissue valves.
文摘We have used artificial chordal replacement with expanded polytetrafluoroethylene sutures for mitral valve repair in children and reported favorable early clinical results. In this article we evaluate the midterm results of mitral valve repair with expanded polytetrafluoroethylene sutures in 39 children. From April 1995 through September 2003, mitral valve repair with chordal replacement using expanded polytetrafluoroethylene sutures was performed in 39 patients. In all patients the preoperative grade of mitral regurgitation was moderate or more because of prolapse of the anterior mitral leaflet. The mean age and body weight at the time of the operation were 4.7±5.3 years(range, 1 month to 17.8 years) and 14.4±12.2 kg(range, 3.9-54.4 kg), respectively. The number of expanded polytetrafluoroethylene sutures ranged from 1 to 3(mean, 1.4). The mean follow-up period and body weight at the latest follow-up were 5.0±2.3 years(range, 1.1-8.5 years) and 25.7±16.4 kg(range, 6.9-73 kg), respectively. There were no operative or late deaths. Only one patient required mitral valve replacement, which occurred 17 days after repair. Two patients underwent redo mitral valve repair 2 and 5 years after initial repair, respectively. The actuarial freedom from reoperation at 5 and 8 years was 94.8%and 89.5%, respectively. At the latest follow-up, trivial or less mitral regurgitation was observed in 33(84.6%) patients. Mitral valve repair with expanded polytetrafluoroethylene sutures in children demonstrated favorable midterm outcome. The procedure is safe and effective,with potential for patients’growth.
