Clinical Evaluation of St.Jude Medical Valve Replacement

St.Jude 기계판막을 이용한 인공심장판막 치환의 외과적 고찰

  • Jin, Ung (Department of Thoracic and Cardiovascular Surgery, Catholic University Medical College) ;
  • Rha, Suk-Joo (Department of Thoracic and Cardiovascular Surgery, Catholic University Medical College) ;
  • Cho, Kyu-Do (Department of Thoracic and Cardiovascular Surgery, Catholic University Medical College) ;
  • Kim, Chi-Kyung (Department of Thoracic and Cardiovascular Surgery, Catholic University Medical College) ;
  • Jo, Keon-Hyon (Department of Thoracic and Cardiovascular Surgery, Catholic University Medical College) ;
  • Wang, Young-Pil (Department of Thoracic and Cardiovascular Surgery, Catholic University Medical College) ;
  • Lee, Sun-Hee (Department of Thoracic and Cardiovascular Surgery, Catholic University Medical College) ;
  • Kwak, Moon-Sub (Department of Thoracic and Cardiovascular Surgery, Catholic University Medical College) ;
  • Kim, Se-Wha (Department of Thoracic and Cardiovascular Surgery, Catholic University Medical College) ;
  • Lee, Hong-Kyun (Department of Thoracic and Cardiovascular Surgery, Catholic University Medical College)
  • 진웅 (가톨릭대학교 의과대학 흉부외과학교실) ;
  • 나석주 (가톨릭대학교 의과대학 흉부외과학교실) ;
  • 조규도 (가톨릭대학교 의과대학 흉부외과학교실) ;
  • 김치경 (가톨릭대학교 의과대학 흉부외과학교실) ;
  • 조건현 (가톨릭대학교 의과대학 흉부외과학교실) ;
  • 왕영필 (가톨릭대학교 의과대학 흉부외과학교실) ;
  • 이선희 (가톨릭대학교 의과대학 흉부외과학교실) ;
  • 곽문섭 (가톨릭대학교 의과대학 흉부외과학교실) ;
  • 김세화 (가톨릭대학교 의과대학 흉부외과학교실) ;
  • 이홍균 (가톨릭대학교 의과대학 흉부외과학교실)
  • Published : 1994.04.01

Abstract

Total 400 St.Jude Medical Bileaflet Valves were implanted in 336 pts from January 1983 to June 1993; 64 were aortic, 205 were mitral, 64 were double valve and 3 were tricuspid position. The follow up period extended from 6 months to 10 years[mean 24.3 months]. Male to female ratio was 1:1.7. There were total 27 deaths[cardiac related 20, cardiac non-related 7]. Overall mortality was 2.9%/pt-yr. There were 10 early deaths[3.0%] and 10 late cardiac related deaths [3.0%]. Prosthetic valve related complications occurred in 19 patients[5.7%] and among them, seven died; four died of thromboembolic events, two died of anticoagulants therapy related hemorrhagic complications and one died of bacterial endocarditis. NYHA class improved significantly especially in aortic valve replacement and double valve replacement. In AVR cases, the mean NYHA was 2.8 preoperatively and 1.3 postoperatively. And in DVR cases, 3.3 preoperatively and 2.2 postoperatively. The decision to employ a particular prosthesis was made according to the anticipated or known complications of the valve. The St.Jude Medical Valve retains all the hazards of other mechanical valves, most notably, thromboembolism. But the hemodynamic performance of St.Jude Medical Valve compared most favorably with other substitute valves in many reports. 0ur experience didn`t show any differences compared other authors in terms of valve related complication. So we concluded St. Jude Medical Valve can be primarily considered in the selection of artificial valve except in the patients when the usage of anticoagulant therapy is contraindicated.

Keywords

References

  1. J Thorac Cardiovasc Surg v.92 Jude Medical valve replacement Robin,H.K.;Manuel,J.A.;Peter,R.C.St.
  2. Am J Surg v.147 The St. Jude Experience Thomas,W.J.;George,I.T.;L.S.S.;Dev,R.M.
  3. J Thorac Cardiovasc Surg v.83 12-year experience with glutaraldehyde preserved porved porcine xenograft Angell,W.W.
  4. J Thorac Cardiovasc Surg v.91 Carpentier-Edwards supura-annular porcine bioprosthesis Jameison,W.R.
  5. J Thorac Cardiovasc Surg v.90 Early and late risk of mitral valve replacement Cohn,L.H.;Allred,E.N.
  6. Ann Thorac Surg v.34 Thromboembolic complication of current cardiac valvular prosthesis Edmunds,L.H.
  7. Quo vadis v.20 Effect of Ticlopidine on platelet function in pateint with valvular prostheses Popa,P.D.;Scrobohaci,M.L.;Fagarasanu,D.;Pavel,D.;Alexandrescu,M.
  8. Cardiology clinics v.3 Thromboembolic complications of prosthetic valves Addonizio,V.P.;Edmunds,L.H.
  9. 대흉외지 v.21 인공심장판막치환 환자에 대한 임상적고찰 곽문섭;나석주;박재길(등)
  10. Rev Esp Cardiol v.44 Resultados clinicos a medio plazo (6 anos) de la bioprotesis de Carpentier-Edwards supraanular Gonzalez Santos,J.M.;Vallejo,J.L.;Sevilla,J.C.(et al.)
  11. 대흉외지 v.22 후천성 심질환의 인공판막 치환술에 대한 임상적 고찰 이준영;지행옥
  12. J Card Surg v.4 Bioprosthetic versus mechanical valve replacement in patients with infective endocarditis Reul,G.J.;Sweeney,M.S.
  13. J Cardiovasc Surg v.32 Bioprosthetic valve endocarditis:factors affecting bad outcome Gagliardi,C.;Di Tommaso,L.;Mastroroberto,P.;Stassano,P.;Spampinato,N.
  14. J Card Surg v.4 Valve replacement for infective endocarditis:an over-view Cohn,L.H.
  15. J Cardiovasc Surg v.32 no.4 Paraprosthetic leak:a complication of cardiac valve replacement Jindani,A;Neville,E.M.;Venn,G.;Williams,B.T.
  16. J Thorac Cardiovasc surg v.89 Clinical durability of the Hancock porcine bioprosthetic valve Oyer,P.E.
  17. Surg Clin North Am v.65 Current status of valve prostheses Morgan,R.J.;Davis,J.T.;Fraker,T.D.