Eight-year follow-up after prospectively randomized implantation of different mechanical aortic valves |
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Authors: | Sven Lehmann Thomas Walther Sergey Leontyev Jörg Kempfert Ardawan Rastan Volkmar Falk Friedrich W Mohr |
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Institution: | 1.Universit?t Leipzig, Herzzentrum, Klinik für Herzchirurgie,Leipzig,Germany |
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Abstract: | Objective The aim of this prospectively randomized study was to evaluate the hemodynamic and functional outcomes after aortic valve
replacement with three different bileaflet mechanical valves.
Methods From March 1996 to August 1998, 300 consecutive patients were randomly assigned to receive ATS (n = 100), Carbomedics (n = 100), or St Jude Medical Hemodynamic Plus (n = 100) mechanical aortic valve replacement. There were no significant differences regarding patient age (61 ± 8 years), gender,
NYHA, aortic valve pathology, ventricular morphology, ejection fraction and requirement for additional procedures at implant.
Mean follow-up extends to 95 ± 21 months at a total of 2,891 patients years and is in 95.3% complete.
Results Implanted valve sizes were comparable at 24 ± 2 mm (ATS), 23.7 ± 1.6 mm (CM), and 23.6 ± 1.9 mm (SJMHP) (NS). Follow-up results
were: transvalvular flow velocities 2.3/2.3/2.2 m/s, ejection fraction 64/59/63%, trivial transvalvular incompetence 3/3/2;
paravalvular leak 2/3/2; freedom of reoperation 100/99/99%, NYHA functional status 1.5/1.8/1.6, overall survival 86.4/82.8/80.6%,
freedom from thrombembolic events 100/96/98%, freedom from hemorrhage 100/100/99%, freedom from all valve related events was
100/96/98%; respectively (NS). There were no episodes of endocarditis. Ninety-four percent of the patients were satisfied
with the procedure enjoying an enhanced daily life activity.
Conclusions There are no clinically relevant differences among the tested bileaflet aortic valves. Regardless of valve type, there was
a rather low complication rate in this relatively young population. All three bileaflet prostheses are well suited for aortic
valve replacement. |
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Keywords: | aortic valve replacement mechanic valve replacement follow-up prospective randomized study |
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