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Late Results and Complications of Prosthetic Aortic Valves

  • Frank E. Kloster
  • Edward Murphy
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 85)

Abstract

The major determinant of late results after valve replacement for chronic aortic regurgitation is left ventricular function, as has been discussed in detail in the preceding chapters. The other important factors in late mortality and morbidity are the characteristics of the different aortic valve prostheses, particularly valve-related complications and durability. This chapter will deal primarily with late postoperative results and complications in relation to aortic prosthetic valve function, since left ventricular function was covered in detail previously. A brief review of the evolution of the various aortic valve prostheses and factors directing their development and modification is helpful in understanding their advantages, disadvantages, and complications.

Keywords

Aortic Valve Valve Replacement Aortic Valve Replacement Prosthetic Valve Mechanical Valve 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Lefrak EA, Starr A. Cardiac Valve Prostheses. Appleton-Century-Crofts, New York, 1979.Google Scholar
  2. 2.
    Bonchek LI. Current status of cardiac valve replacement: Selection of a prosthesis and indications for operation. Am Heart J 101:96–106, 1981.PubMedCrossRefGoogle Scholar
  3. 3.
    Silverman NA, Levitsky S. Current choices for prosthetic valve replacement. Mod Conc Cardiovasc Dis 52:35–39, 1983.Google Scholar
  4. 4.
    Starr A, Grunkemeier GL. Selection of a prosthetic heart valve. JAMA 251:1739–1742, 1984.PubMedCrossRefGoogle Scholar
  5. 5.
    Hylen JC, Kloster FE, Starr A., Griswold HE. Aortic ball variance: Diagnosis and treatment. Ann Int Med 72:1–8, 1970.PubMedGoogle Scholar
  6. 6.
    Herr RH, Starr A, Pierie WR, Wood JA, Bigelow JC. Aortic valve replacement: A review of six years experience with ball-valve prosthesis. Ann Thorac Surg 6:199–218, 1968.PubMedCrossRefGoogle Scholar
  7. 7.
    Bonchek LI, Starr A. Ball valve prostheses: Current appraisal of late results. Am J Cardiol 35:843–854, 1975.PubMedCrossRefGoogle Scholar
  8. 8.
    Stein DW, Rahimtoola SH, Kloster FE, Seiden R, Starr A. Thrombotic phenomena with nonanticoagulated composite-strut aortic prostheses. J Thorac Cardiovasc Surg 71:680–684, 1976.PubMedGoogle Scholar
  9. 9.
    Isom WO, Spencer FC, Glassman E, Tieko P, Boyd A, Cunningham JN, Reed GE. Long-term results in 1375 patients undergoing valve replacement with the Starr-Edwards cloth-covered steel ball prosthesis. Ann Surg 186:310–322, 1977.PubMedCrossRefGoogle Scholar
  10. 10.
    Miller DC, Oyer PE, Mitchell RS, Stinson EB, Jamieson SW, Baldwin JC. Performance characteristics of the Starr-Edwards Model 1260 aortic valve prosthesis beyond ten years. J Thorac Cardiovasc Surg 88: 193–207, 1984.PubMedGoogle Scholar
  11. 11.
    McGoon MD, Fuster V, McGood DC, Pumphrey CW, Pluth JR, Elveback LR. Aortic and mitral incompetence: Long-term follow-up (10–19 years) of patients treated with the Starr-Edwards prosthesis. J Am Coll Cardiol 3:930–938, 1984.PubMedCrossRefGoogle Scholar
  12. 12.
    Bjork VO, Henze A. Ten years experience with the Bjork-Shiley tilting disc valve. J Thorac Cardiovasc Surg 78:331–342, 1979.PubMedGoogle Scholar
  13. 13.
    Karp RB, Cyrus RJ, Blackstone EH, Kirklin JW, Kouchoukos NT, Pacific AD. The Bjork-Shiley valve. Intermediate-term follow-up. J Thorac Cardiovasc Surg 81:602–614, 1981.PubMedGoogle Scholar
  14. 14.
    Bjork VO, Lindblom D. The monostrut Bjork-Shiley heart valve. J Am Coll Cardiol 6:1142–1148, 1985.PubMedCrossRefGoogle Scholar
  15. 15.
    McHenry MM, Smeloff EA, Matloff HJ, Rice J, Miller GE. Long-term survival after single aortic or mitral valve replacement with the present models of Smeloff-Cutter valves. J Thorac Cardiovas Surg 75:709–715, 1978.Google Scholar
  16. 16.
    Blackstone EH, Kirklin JW, Pluth JR, Turner ME, Parr GU. The performance of the Braunwald-Cutter aortic prosthetic valve. Ann Thorac Surg 23:302–318, 1977.PubMedCrossRefGoogle Scholar
  17. 17.
    McGovern GJ, Liebler GA, Cushing WJ, Park SB, Burkholder JA. A thirteen-year review of the McGovern-Cromie aortic valve. J Thorac Cardiovasc Surg 73:64–75, 1977.Google Scholar
  18. 18.
    Starek PJ, McLaurin P, Wilcox BR, Murray GF. Clinical evaluation of the Lillihei-Kaster pivoting disc valve. Ann Thorac Surg 22:362–368, 1976.PubMedCrossRefGoogle Scholar
  19. 19.
    Nicoloff DM, Emery RW, Arom KV, Northrup WF, Jorgenson CR, Wang Y, Lindsay WG. Clinical and hemodynamic results with the St. Jude Medical cardiac valve prosthesis. J Thorac Cardiovasc Surg 82:674–683, 1981.PubMedGoogle Scholar
  20. 20.
    Baudet EM, Oca CC, Roques XF, Laborde MN, Hafez AS, Collot MA, Ghidoni IM. A 5 1/2 year experience with the St. Jude Medical cardiac valve prosthesis. J Thorae Cardiovas Surg 90:137–144, 1985.Google Scholar
  21. 21.
    Czer LS, Matloff J, Chaux A, DeRobertis M, Yoganathan A, Gray RJ. A 6 year experience with the St. Jude Medical valve: Hemodynamic performance, surgical results, biocompati-bility and follow-up. J Am Coll Cardiol 6:904–912, 1985.PubMedCrossRefGoogle Scholar
  22. 22.
    Ross DN, Yacoub MH. Homograft replacement for aortic valve disease. A critical review. Progr Cardiovasc Dis 11:275–293, 1969.CrossRefGoogle Scholar
  23. 23.
    Barratt-Boyes BG, Roche AH, Whitlock RM. Six year review of the results of freehand aortic valve replacement using an antibiotic sterilized homograft. Circulation 55:353–361, 1977.PubMedGoogle Scholar
  24. 24.
    Angell WW, Shumway NE. Valve replacement: Present status of homograft valves. Progr Cardiovasc Dis 15: 589–623, 1972.CrossRefGoogle Scholar
  25. 25.
    Carpentier A, Deloche A, Relland J, Fabiani JN, Forman J, Camilleri JP, Soyer R, Dubost C. 1974. Six-year follow-up of gluteraldehyde-preserved heterografts with particular reference to treatment of congenital valve malformations. J Thorac Cardiovasc Surg 68: 771–782, 1974.Google Scholar
  26. 26.
    Reis RL, Hancock WD, Yarbrough JW, Glancy DL, Morrow AG. The flexible stent: A new concept in the fabrication of tissue valve prostheses. J Thorc Cardiovasc Surg 62:683–689, 1971.Google Scholar
  27. 27.
    Stinson EB, Griepp RB, Oyer PE, Shumway NE. Long-term experience with porcine aortic valve xenografts. J Thorac Cardiovasc Surg 73:54–63, 1977.PubMedGoogle Scholar
  28. 28.
    Cohn LH, Koster JK, Mee RB, Collins JJ. Long-term follow-up of the Hancock bioprosthetic heart valve. Circulation (Supp I) 60:87–92, 1979.Google Scholar
  29. 29.
    Oyer PE, Miller DC, Stinson EB, Reitz BA, Moreno-Cabral RJ, Shumway NE. Clinical durability of the Hancock porcine bioprosthetic valve. J Thorac Cardiovasc Surg 80:824–833, 1980.PubMedGoogle Scholar
  30. 30.
    Cohn LH, Mudge GH, Pratter F, Collins JJ. Five to eight year follow-up of patients undergoing heart-valve replacement. New Engl J Med 304:258–262, 1981.PubMedCrossRefGoogle Scholar
  31. 31.
    Carpentier A, Dubost C, Lane E, Nashef A, Carpentier S, Relland J, Deloche A, Fabiani J-N, Chauvaud S, Perier P, Maxwell S. Continuing improvements in valvular bioprostheses. J Thorac Cardiovasc Surg 83:27–42, 1982.PubMedGoogle Scholar
  32. 32.
    Ionescu MI, Tandon AP, Mary DA, Abid A. Heart valve replacement with the Ionescu-Shiley pericardial xenograft. J Thorac Cardiovas Surg 73:31–42, 1977.Google Scholar
  33. 33.
    Becker RM, Sandor L, Tindel M, Frater RW. Medium term follow-up of the Ionescu-Shiley heterograft valve. Ann Thorac Surg 32:120–126, 1981.PubMedCrossRefGoogle Scholar
  34. 34.
    Teply JF, Grunkemeier GL, Sutherland HD, Lambert L, Johnson VA, Starr A. The ultimate prognosis after valve replacement: An assessment at twenty years. Ann Thorac Surg 32:111–119, 1981.PubMedCrossRefGoogle Scholar
  35. 35.
    Rahimtoola SH. Valvular heart disease: A perspective. J Am Coll Cardiol 1:199–215, 1983.PubMedCrossRefGoogle Scholar
  36. 36.
    Turina J, Turina M, Rothlin M, Krayenbuehl HP. Improved late survival in patients with chronic aortic regurgitation by earlier operation. Circulation 70 (Suppl I): 147–152, 1984.Google Scholar
  37. 37.
    Rahimtoola SH. Valvular heart disease: The decision to treat. Hospital Practice: 63–78, 1984.Google Scholar
  38. 38.
    Oyer PE, Stinson EB, Griepp RB, Shumway NE. Valve replacement with the Starr-Edwards and Hancock prostheses: Comparative analysis of late morbidity and mortality. Ann Surg 3:301–307, 1977.CrossRefGoogle Scholar
  39. 39.
    Joyce LD, Nelson RM. Comparison of porcine valve xenografts with mechanical prostheses. A 71/2 year experience. J Thorac Cardiovas Surg 88:102–113, 1984.Google Scholar
  40. 40.
    Cohn LH, Allred EN, DiSesa VJ, Sawtelle K, Shemin RJ, Collins JJ. Early and late risk of aortic valve replacement. A 12 year concomittant comparison of the porcine bioprosthesis and tilting disc prosthetic aortic valves. J Thorac Cardiovas Surg 88:695–705, 1984.Google Scholar
  41. 41.
    Perier P, Bessou JP, Swanson JS, Benasson D, Chacques JC, Chauvaud S, Deoche A, Fabian JN, Blondeau P, d’Allaines C, Carpentier A. Comparative evaluation of aortic valve replacement with Starr, Bjork, and porcine valve prostheses. Circulation (Suppl II)140–145, 1985.Google Scholar
  42. 42.
    Bonow RO, Picone AL, Mcintosh CL, Jones M, Rosing DR, Maron BJ, Lakatos E, Clark RE, Epstein SE. Survival and functional results after valve replacement for aortic regurgitation from 1976 to 1983: Impact of preoperative left ventricular function. Circulation 72:1244–1256, 1985.PubMedCrossRefGoogle Scholar
  43. 43.
    Acar J, Luxereau P, Ducimetiere P, Cadilhac M, Jallut H, Vahanian A. Prognosis of surgically treated chronic aortic valve disease. J Thorac Cardiovas Surg 82:114–126, 1981.Google Scholar
  44. 44.
    Louagie Y, Brohet C, Robert A, Lopez E, Jaumin P, Schoevaerdts J-C, Chalant C-H. Factors influencing post-operative survival in aortic regurgitation. J Thorac Cardiovasc Surg 88:225–233, 1984.PubMedGoogle Scholar
  45. 45.
    Blackstone EH, Kirklin JW. Death and other time-related events after valve replacement. Circulation 72:753–767, 1985.PubMedCrossRefGoogle Scholar
  46. 46.
    Bloomfield P, Kitchin AH, Wheatley DJ, Walbaum P, Lutz W, Miller H. A prospective evaluation of the Bjork-Shiley, Hancock and Carpentier-Edwards heart valve prostheses. Circulation 73:1213–1222, 1986.PubMedCrossRefGoogle Scholar
  47. 47.
    Hirschfeld JW, Epstein SE, Robert AJ, Glancy DL, Morrow AG. Indices predicting longterm survival after valve replacement in patients with aortic regurgitation and patients with aortic stenosis. Circulation 50:1190–1199, 1974.Google Scholar
  48. 48.
    Schwarz F, Bauman P, Manthey J, Hoffman M, Schüler G, Mehmel HC, Schmitz W, Kubler W. The effect of aortic valve replacement on survival. Circulation 66:1105–1110, 1982.PubMedCrossRefGoogle Scholar
  49. 49.
    Anderson RP, Bonchek LI, Grunkemeier GL, Lambert LE, Starr A. The analysis and presentation of surgical results by actuarial methods. J Surg Res 16:224–231, 1974.PubMedCrossRefGoogle Scholar
  50. 50.
    Grunkemeier GL, Starr A. Actuarial analysis of surgical results: Rationale and method. Ann Thorac Surg 24:404–408, 1977.PubMedCrossRefGoogle Scholar
  51. 51.
    Stone PH, Clark RD, Goldschlager N, Selzer A, Cohn K. Determinants of prognosis of patients with aortic regurgitation who undergo aortic valve replacement J Am Coll Cardiol 3:118–1126, 1984.CrossRefGoogle Scholar
  52. 52.
    Barnhorst DA, Oxman HA, Connolly DC, Pluth JR, Danielson GK, Wallace RB, McGoon DC. Long-term follow-up of isolated replacement of the aortic or mitral valve with the Starr-Edwards prosthesis. Am J Cardiol 35:228–233, 1975.PubMedCrossRefGoogle Scholar
  53. 53.
    Rubin JW, Moore HV, Hillson RF, Ellison RG. Thirteen year experience with aortic valve replacement. Am J Cardiol 40:345–354, 1977.PubMedCrossRefGoogle Scholar
  54. 54.
    Copeland JG, Griepp RB, Stinson EB, Shumway NE. Long-term follow-up after isolated aortic valve replacement. J Thorac Cardiovas Surg 875–889, 1977.Google Scholar
  55. 55.
    Macmanus Q, Grunkemeier GL, Lambert LE, Starr A. Non-cloth-covered caged-ball prostheses. J Thorac Cardiovas Surg 76:788–794, 1978.Google Scholar
  56. 56.
    Schoen FJ, Collins JJ, Cohn LH Long-term failure rate and morphologic correlations in porcine bioprosthetic heart valves. Am J Cardiol 51:957–964, 1983.PubMedCrossRefGoogle Scholar
  57. 57.
    Austen WG. Heart valve substitutes. In Johnson A, Haber E, Austen WG (eds) The Practice of Cardiology. Little, Brown, Boston 1980, pp 527–569.Google Scholar
  58. 58.
    Lipson L, Kent K, Rosing D, Bonow R, Mcintosh C, Condit J, Epstein S, Morrow A. Long-term hemodynamic assessment of the porcine heterograft in the mitral position. Circulation 64:397–401, 1981.PubMedCrossRefGoogle Scholar
  59. 59.
    Milano A, Bortolotti U, Talenti E. Calcific degeneration as the main cause of porcine bioprosthetic valve failure. Am J Cardiol 53:1066–1070, 1983.CrossRefGoogle Scholar
  60. 60.
    Reinhart SE, DeMots H, Murphy ES, Khonsari S, Starr A. Late in vivo hemodynamics and hemodynamics of maximal exercise for the silastic ball aortic prosthesis. J Am Coll Cardiol 3:602, 1984.Google Scholar
  61. 61.
    Carabello BA, Grossman W. Calculation of stenotic valve orifice area. In Grossman W (ed) Cardiac Catheterization and Angiography, Lea & Febiger, Philadelphia, 1986, pp 143–154.Google Scholar
  62. 62.
    Ubago JL, Figueroa A, Colman T, Ochoteco A, Duran CG. Hemodynamic factors that affect calculated orifice areas in the mitral Hancock zenograft valve. Circulation 61:388–394, 1980.PubMedGoogle Scholar
  63. 63.
    Chaitman BR, Bonan R, Lepage G, Tubau JF, David PR, Dyrda I, Grondin C. Hemodynamic evaluation of the Carpentier-Edwards porcine zenograft. Circulation 60:1170–1182, 1979.PubMedGoogle Scholar
  64. 64.
    Follano E, Parisi A, Carbone C. Is peripheral arterial pressure a satisfactory substitute for ascending aortic pressure when measuring aortic valve gradients? J Am Coll Cardiol 4:1207–1212, 1984.CrossRefGoogle Scholar
  65. 65.
    Gray RJ, Chaux A, Matloff JM, DeRobertis M, Raymond M, Stewart M, Yoganathan A. Bileaflet, tilting disc and porcine aortic valve substitutes: In vivo hydrodynamic characteristics. J Am Coll Cardiol 3:321–327, 1984.PubMedCrossRefGoogle Scholar
  66. 66.
    Hatle L, Angelsen B. Pulsed and continuous wave Doppler in diagnosis and assessment of various heart lesions. In Doppler Ultrasound in Cardiology. Lea & Febiger, Philadelphia, 1985, pp 97–292.Google Scholar
  67. 67.
    Panidis IP, Ross J, Mintz GS. Normal and abnormal prosthetic valve function as assessed by Doppler echocardiography. J Am Coll Cardiol 8:317–326, 1986.PubMedCrossRefGoogle Scholar
  68. 68.
    Sagar KB, Wann LS, Paulsen WH, Ramhilt DW. Doppler echocardiographic evaluation of Hancock and Bjork-Shiley prosthetic valves. J Am Coll Cardiol 7:681–687, 1986.PubMedCrossRefGoogle Scholar
  69. 69.
    Brott WH, Zajtchuk R, Bowen TE, Davia J, Green DC. Dipyridamole-aspirin as thromboembolic prophylaxis in patients with aortic valve prosthesis: Prospective study with the model 2320 Starr-Edwards prosthesis. J Thorac Cardiovas Surg 81:632–635, 1981.Google Scholar
  70. 70.
    Hartz RS, Locicero J, Kucich V, DeBoer A, O’Mara S, Meyers SN, Michaelis LL. Comparative study of warfarin verous antiplatelet therapy in patients with a St. Jude Medical valve in the aortic position. J Thorac Cardiovas Surg 92:684–690, 1986.Google Scholar
  71. 71.
    Chesebro JH, Fuster V, Elveback L, McGoon DC, Pluth JR, Puga FJ, Wallace RB, Danielson FK, Orszulak TA, Piehler JM, Schaff HV. Trial of combined warfarin plus dipyridamole or aspirin therapy in prosthetic heart valve replacement. Am J Cardiol 51:1537–1541, 1983.PubMedCrossRefGoogle Scholar
  72. 72.
    Lieberman A, Hass WK, Pinto R, Isam WO, Kupersmith M, Bear G, Chase R. Intracranial hemorrhage and infarction in anticoagulated patients with prosthetic heart valves. Stroke 9:18–24, 1978.PubMedCrossRefGoogle Scholar
  73. 73.
    Ivert TS, Dismukes WE, Cobbs CG, Blackstone EH, Kirklin JW, Bergdahl LA. Prosthetic valve endocarditis. Circulation 69:223–232, 1984.PubMedCrossRefGoogle Scholar
  74. 74.
    Wilson WR, Danielson GK, Giuliani E, Geraci JE. Prosthetic valve endocarditis. Mayo Clin Proc 57:155–161, 1982.PubMedGoogle Scholar
  75. 75.
    Alsip SG, Blackstone EH, Kirklin JW, Oobbs GC. Indications for cardiac surgery in patients with active infective endocarditis. Am J Med 78(suppl 6B):138–148, 1985.PubMedCrossRefGoogle Scholar
  76. 76.
    Shulman ST, Amren DP, Bisno AL, Dajani AS, Durack DT, Gerber MA, Kaplan EL, Millard HD, Sanders WE, Schwartz RH, Watakunakorn C. Prevention of bacterial endocarditis. Circulation 70:1123A–1127A, 1984.PubMedGoogle Scholar
  77. 77.
    Kloster FE, Faraehi C, Mourdjinis A, Hodom RP, Starr A, Griswold HE. Hemodynamic studies in patients with cloth-covered composite-seat Starr-Edwards valve prostheses. J Thorac Cardiovasc Surg 60:879–888, 1970.PubMedGoogle Scholar
  78. 78.
    Lindblom D, Bjork VO, Semb BK. Mechanical failure of the Bjork-Shiley valve. J Thorac Cardiovasc Surg 92:894–907, 1986.PubMedGoogle Scholar
  79. 79.
    Metzdorff MT, Grunkemeier GL, Pinson CW, Starr A. Thrombosis of mechanical cardiac valves: A quantitative comparison of the silastic ball valve and the tilting disc valve. J Am Coll Cardiol 4:50–53, 1984.PubMedCrossRefGoogle Scholar
  80. 80.
    Ryder SJ, Bradley H, Brannan JJ, Turner MA, Bain WH. Thrombotic obstruction of the Bjork-Shiley valve: The Glasgow experience. Thorax 39:487–492, 1984.PubMedCrossRefGoogle Scholar
  81. 81.
    Ledain LD, Ohayon JP, Colle JP, Lorient-Roudaut FM, Roudaut RP, Besse PM. Acute thrombotic obstruction with disc valve prostheses: Diagnostic considerations and fibrinolytic treatment. J Am Coll Cardiol 7:743–751, 1986.PubMedCrossRefGoogle Scholar
  82. 82.
    Gallo I, Bianca R, Nistal F, Duran CMG. Degeneration in porcine bioprosthetic cardiac valves: Incidence of primary tissue failures among 938 bioprostheses at risk. Am J Cardiol 53:1061–1065, 1984.PubMedCrossRefGoogle Scholar
  83. 83.
    Magilligan DJ, Lewis JW, Jara FM, Lee MW, Alan M, Riddle JM, Stein PD. Spontaneous degeneration of porcine bioprosthetic valves. Ann Thorac Surg 30:259–265, 1980.PubMedCrossRefGoogle Scholar
  84. 84.
    Cohn LH, Loster JK, Vanse Vanter S, Collins JJ. The in-hospital risk of re-replacement of dysfunctional mitral and aortic valves. Circulation (suppl I):153–156, 1982.Google Scholar
  85. 85.
    Orszulak TA, Schaff HV, Danielson G, Pluth JR, Puga FJ, Piehler JM. Results of reoperation for periprosthetic leakage. Ann Thorac Surg 35:584–589, 1983.PubMedCrossRefGoogle Scholar
  86. 86.
    Kloster FE. Diagnosis and management of complications of prosthetic heart valves. Am J Cardiol 35:872–885, 1975.PubMedCrossRefGoogle Scholar
  87. 87.
    Santinga JT, Kirsh M, Flora JD, Brymer FJ. Factors related to late sudden death in patients having aortic valve replacement. Ann Thorac Surg 29:249–253, 1978.CrossRefGoogle Scholar
  88. 88.
    Stevenson RE, Burton OM, Ferlauto GS, Taylor HA. Hazards of oral anticoagulation during pregnancy. JAMA 243:1549–1551, 1980.PubMedCrossRefGoogle Scholar
  89. 89.
    Iturbe-Alessio I, Carmen Fonseca M, Mutchinik O, Santos M, Zajarias A, Salazar E. Risks of anticoagulation therapy in pregnant women with artificial heart valves. N Engl J Med 315:1390–1393, 1986.PubMedCrossRefGoogle Scholar
  90. 90.
    Kalholi RE, Nolan SP, McGuire LB. The management of anticoagulation during noncardiac operations in patients with prosthetic heart valves: A prospective study. Am Heart J 96:163–165, 1978.CrossRefGoogle Scholar
  91. 91.
    Tinker JH, Tarhan S. Discontinuing anticoagulant therapy in surgical patients with cardiac valve prostheses: Observations in 180 operations. JAMA 239:738–739, 1978.PubMedCrossRefGoogle Scholar

Copyright information

© Kluwer Academic Publishers 1988

Authors and Affiliations

  • Frank E. Kloster
  • Edward Murphy

There are no affiliations available

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