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When and how does nonstructural mechanical prosthetic heart valve dysfunction occur?

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Abstract

Objective: We diseuss the clinical aspects related to mechanical valve dysfunction based upon 20 years' experience of our cases.Methods: Between January 1982 and December 2001, 21 patients underwent surgical interventions because of mechanical valve dysfunction. Thirteen men and 8 women (mean age 47±20, range 3–75 years-old), were included.Results: Mitral valve dysfunction was observed in 12 patients. Prosthetic valve stenosis occurred in 6 patients between 2 and 224 months, and paravalvular leaks in 4 between 1 and 71 months after surgery. The other 2 patients suffered from hemolytic anemia with mild paravalvular leaks between 102 and 104 months after surgery. Aortic valve dysfunction was observed in 8 patients including 3 stenotic lesions between 48 and 97 months and 5 paravalvular leaks between 3 and 150 months after surgery. Tricuspid regurgitation was seen in 1 patient with a huge right atrium at 42 months after surgery. Early death was seen in 1 patient. Late death occurred in 1 patient, 17 years after operation. Survival, including early death, was 95.2% at 10 and 15 years. One valve-related complication of bioprosthetic valve endocarditis at the mitral and tricuspid positions occurred 12 years after a reoperation. The freedom from complications was 95.2% at 10 years, and 76.2% at 15 years.Conclusions: Paravalvular leaks without overt endocarditis had latency periods of up to 12 years, and pannus formation was observed 20 years after surgery. Early and late clincal results after surgery for mechanical valve dysfunction were excellent.

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References

  1. Dalrymple-Hay MJ, Pearce R, Dawkins S, Haw MP, Lamb RK, Livesey SA, et al. A single-center experience with 1,378 CarboMedics mechanical valve implants. Ann Thorac Surg 2000; 69: 457–63.

    Article  PubMed  CAS  Google Scholar 

  2. North RA, Sadler L, Stewart AW, McCowan, LM, Kerr AR, White HD. Long-term survival and valverelated complications in young women with cardiac valve replacements. Circulation 1999; 99: 2669–76.

    PubMed  CAS  Google Scholar 

  3. Mueller XM, Tevaearai HT, Stumpe F, Fischer AP, Hurni M, Ruchat P, et al. Long-term results of mitralaortic valve operations. J Thorac Cardiovasc Surg 1998; 115: 1298–309.

    Article  PubMed  CAS  Google Scholar 

  4. Hurle A, Abad C, Feijoo J, Ray V, Ponce G. Long-term clinical performance of Sorin tilting-disc mechanical prostheses in the mitral and aortic position. J Cardiovasc Surg 1997; 38: 507–12.

    CAS  Google Scholar 

  5. Fernandez J, Laub GW, Adkins MS, Anderson WA, Chen C, Bailey BM, et al. Early anid late-phase events after valve replacement with the St. Jude Medical prosthesis in 1200 patients. J Thorac Cardiovasc Surg 1994; 107: 394–406.

    PubMed  CAS  Google Scholar 

  6. Keenan RJ, Armitage JM, Trento A, Siewers RD, Hardesty RL, Bahnson HT, et al. Clinical experience with the Medtronic-Hall valve prosthesis. Ann Thorac Surg 1990; 50: 748–53.

    Article  PubMed  CAS  Google Scholar 

  7. Li HH, Hahn J, Urbanski P, Torka M, Grunkemeier GL, Hacker RW. Intermediate-term results with 1,019 CarboMedics aortic valves. Ann Thorac Surg 2001; 71: 1181–7.

    Article  PubMed  CAS  Google Scholar 

  8. Fiane AE, Geiran OR, Svennevig JL. Up to eight years' follow-up of 997 patients receiving the CarboMedics prosthetic heart valve. Ann Thorac Surg 1998; 66: 443–8.

    Article  PubMed  CAS  Google Scholar 

  9. Copeland JG 3rd, Sethi GK. Four-year experience with the CarboMedics valve: The North American experience: North American team of clinical investigators for the CarboMedics prosthetic heart valve. Ann Thorac Surg 1994; 58: 630–7.

    Article  PubMed  Google Scholar 

  10. Remadi JP, Bizouarn P, Baron O, Al Habash O, Despins P, Michaud JL, et al. Mitral valve replacement with the St. Jude Medical prosthesis A 15-year follow-up. Ann Thorac Surg 1998; 66: 762–7.

    Article  PubMed  CAS  Google Scholar 

  11. Lund O, Nielsen SL, Arildsen H, Ilkjaer LB, Pilegaard HK. Standard aortic St. Jude valve at 18 years: Performance profile and determinants of outcome. Ann Thorac Surg 2000; 69: 1459–65.

    Article  PubMed  CAS  Google Scholar 

  12. Katircioglu SF, Yamak B, Ulus AT, Tasdemir O, Bayazit K. Mitral valve replacement with St. Jude Medical prosthesis and low-dose anticoagulation in patients aged over 50 years. J Heart Valve Dis 1998; 7: 455–9.

    PubMed  CAS  Google Scholar 

  13. Arom KV, Nicoloff DM, Kersten TE, Northrup WF 3rd, Lindsay WG, Emery RW. Ten-year follow-up study of patients who had double valve replacement with the St. Jude Medical prosthesis. J Thorac Cardiovasc Surg 1989; 98: 1008–15.

    PubMed  CAS  Google Scholar 

  14. de la Fuente A, Sanchez R, Romero J, Berjon J, Imizcoz MA, Fernandez JL, et al. CarboMedics and Monostrut valves: Clinical and hemodynamic outcomes in a randomized study. J Heart Valve 2000; 9: 303–7.

    Google Scholar 

  15. Buttard P, Bonnefoy E, Chevalier P, Marcaz PB, Robin J, Obadia JF, et al. Mechanical cardiac valve thrombosis in patients with critical hemodynamic compromise. Eur J Cardiothorac Surg 1997; 11: 710–3.

    Article  PubMed  CAS  Google Scholar 

  16. Genoni M, Franzen D, Vogt P, Seifert B, Jenni R, Kunzli A, et al. Parvvalvular leakage after mitral valve replacement: Improved long-term survival with aggressive surgery? Eur J Cardiothorac Surg 2000; 17: 14–9.

    Article  PubMed  CAS  Google Scholar 

  17. Ninomiya M, Yagyu K, Kaneko Y, Kotsuka Y, Takamoto S. Hemolysis after mitral valve replacement with mechanical valve prostheses. Jpn J Thorac Cardiovasc Surg 2001; 49: 230–5.

    Article  PubMed  CAS  Google Scholar 

  18. Faletra F, Constantin C, De Chiara F, Masciocco G, Santambrogio G, Moreo A, et al. Incorrect echocardiographic diagnosis in patients with mechanical prosthetic valve dysfunction: Correlation with surgical findings. Am J Med 2000; 108: 531–7.

    Article  PubMed  CAS  Google Scholar 

  19. Barbetseas J, Zoghbi WA, Evaluation of prosthetic valve function and associated complications. Cardiol Clin 1998; 16: 505–30.

    Article  PubMed  CAS  Google Scholar 

  20. Lengyel M. The impact of transesophageal echocardiography on the management of prosthetic valve endocarditis: Experience of 31 cases and review of the Iiterature. J Heart Valve Dis 1997; 6: 204–11.

    PubMed  CAS  Google Scholar 

  21. Smith RE, Berg D. Occult paravalvular leak in a clinically normal St. Jude's mitral valve presenting with life-threatening microangiopathic hemolytic anemia. J Cardiovas Surg 1991; 32: 56–8.

    CAS  Google Scholar 

  22. Cerfolio RJ, Orszulak TA, Daly RC, Schaff HV. Reoperation for hemolytic, anaemia complicating mitral valve repair. Eur J Cardio-thorac Surg 1997; 11: 479–84.

    Article  CAS  Google Scholar 

  23. Misawa Y, Hasegawa T, Kato M. Clinical experience with the Omnicarbon prosthetic heart valve. J Thorac Cardiovasc Surg 1993; 105: 168–72.

    PubMed  CAS  Google Scholar 

  24. Rallidis LS, Moyssakis IE, Ikonomidis I, Nihoyannopoulos P. Natural history of early aortic paraprosthetic regurgitation: A five-year follow-up. Am Heart J 1999; 138: 351–7.

    Article  PubMed  CAS  Google Scholar 

  25. Misawa Y, Fuse K, Kato M. Pannus resection through the tilting disc prosthesis: Successful treatment preserving the prosthesis. Artif Organs 1997; 21: 1301–2.

    Article  PubMed  CAS  Google Scholar 

  26. Jones JM, O'kane H, Gladstone DJ, Sarsam MA, Campalani G, MacGowan SW, et al. Repeat heart valve surgery: Risk factors for operative mortality. J Thorac Cardiovasc Surg 2001; 122: 913–8.

    Article  PubMed  CAS  Google Scholar 

  27. Guerra JM, Tornos MP, Permanyer-Miralda G, Almirante B, Murtra M, Soler-Soler J. Long term results of mechanical prostheses for treatment of active infective endocarditis. Heart 2001; 86: 63–8.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Division of Cardiovascular Surgery, Jichi Medical School, 3311-1 Yakushiji, Minami-kawachi, 329-0498, Tochigi, Japan

    Yoshio Misawa MD, Tsutomu Saito MD, Hiroaki Konishi MD, Shin-ichi Oki MD, Yuichiro Kaminishi MD, Hideki Takahashi MD, Kei Aizawa MD, Osamu Kamisawa MD, Morito Kato MD & Katsuo Fuse MD

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  1. Yoshio Misawa MD
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  2. Tsutomu Saito MD
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  3. Hiroaki Konishi MD
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  4. Shin-ichi Oki MD
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  5. Yuichiro Kaminishi MD
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  6. Hideki Takahashi MD
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  7. Kei Aizawa MD
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  8. Osamu Kamisawa MD
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  9. Morito Kato MD
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  10. Katsuo Fuse MD
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Misawa, Y., Saito, T., Konishi, H. et al. When and how does nonstructural mechanical prosthetic heart valve dysfunction occur?. Jpn J Thorac Caridovasc Surg 51, 355–360 (2003). https://doi.org/10.1007/BF02719467

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  • DOI: https://doi.org/10.1007/BF02719467

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