THE ST-JUDE-MEDICAL-PROSTHESIS IN THE MITRAL POSITION

被引:14
作者
ISOMURA, T
HISATOMI, K
HIRANO, A
KOSUGA, K
OHISHI, K
机构
[1] Second Department of Surgery, Kurume University Hospital, Kurume, 830, 67 Asahi-Machi, Fukuoka
关键词
ST JUDE; MEDICAL PROSTHESIS (SJM); MITRAL VALVE REPLACEMENT (MVR); FOLLOW-UP; ANTI-ANATOMICAL POSITION; VALVE-RELATED COMPLICATION;
D O I
10.1016/1010-7940(94)90126-0
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
To study the long-term results of the St. Jude medical prosthesis in the mitral position, 520 patients were evaluated who had undergone mitral valve replacement with St. Jude medical (SJM) prosthesis. Eighteen patients or 3.5% died in the early postoperative period (within 30 days after operation). The total follow-up was 2872 patient-years and late deaths occurred in 23 cases. Postoperative cerebral embolism occurred in six, bleeding complication in five, and thrombosed valve in two patients. Postoperative anti-coagulant therapy was initiated with both dipyridamole (300 mg/day) and warfarin potassium. After discharge from our hospital the patients underwent routine examination of their thrombo-tests or prothrombin times at least every 2-3 months, and the major thromboembolic or bleeding complication rate was 0.45%/100 patient-years. In a period of 12 years, severe hemolysis following implantation was seen in seven patients. The cause of this hemolysis was perivalvular leakage in two patients but there were no leakages in the other five patients, although preoperative moderate to severe liver dysfunction was noted. Ninety-three percent of the patients were followed up, and their postoperative New York Heart Association functional classes were I or II in 88.6% of the cases. Their clinical results after mitral valve replacement with SJM prosthesis in the anti-anatomical position showed excellent durability and a low incidence of valve-related complications.
引用
收藏
页码:11 / 14
页数:4
相关论文
共 12 条
[1]  
Akins C.W., Mechanical cardiac valvular prosthesis, Ann Thorac Surg, 52, pp. 161-172, (1991)
[2]  
Arom K.V., Nicoloff D.M., Kersten T.E., Lindsay W.G., Northrup W., St. Jude medical prosthesis: Valve-related deaths and complications, Ann Thorac Surg, 43, pp. 591-598, (1987)
[3]  
Arom K.V., Nicoloff D.M., Kersten T.E., Northrup W., Lindsay W.G., Emery R.W., Ten years’ experience with the St. Jude medical valve prosthesis, Ann Thorac Surg, 47, pp. 831-837, (1989)
[4]  
Chesebro J.H., Fuster V., Elveback L.R., Trial of combined warfarin plus dipyridamole or aspirin compared with dipyridamole, Am J Cardiol, 51, pp. 1537-1541, (1983)
[5]  
Czer L., Matloff J.M., Chaux A., Derobertis M., Stewart M.E., Gray R.J., The St. Jude valve: Analysis of thromboembolism, warfarin-jelated hemorrhage, and survival, Am Heart J, 114, pp. 389-397, (1987)
[6]  
Czer L., Chaux A., Matloff J.M., Derobertis M.A., Nessim S.A., Scarlata D., Khan S.S., Kass R.M., Tsai T.D., Blanche C., Gray R.J., Ten-year experience with the St., Jude Medical Valve for Primary Valve Replacement, 100, pp. 44-55, (1990)
[7]  
Disesa V.J., Collins J.J., Cohn L.H., Hematological complications with the St. Jude valve and reduced-dose Coumadin, Ann Thorac Surg, 48, pp. 280-283, (1989)
[8]  
Isomura T., Yanai T., Aoyagi S., Akagawa H., Hisatomi K., Ko-Suga K., Ohishi K., Koga M., Clinical study on mitral valve replacement with St. Jude medical prosthesis, Jpn J Thorac Surg, 33, pp. 2102-2108, (1985)
[9]  
Kloster F.E., Diagnosis and management of complications of prosthetic heart valves, Am J Cardiol, 35, pp. 872-885, (1975)
[10]  
Lillehei C.W., The St. Jude medical prosthetic heart valve: Results from a 5-year multicenter experience, Update in Heart Valve Replacement, pp. 3-23, (1986)