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The Journal of Cardiovascular Surgery 2000 April;41(2):247-9

Copyright © 2009 EDIZIONI MINERVA MEDICA

lingua: Inglese

Mitral valve replacement with small-sized tilting-disc mechanical prostheses may lead to moderate stenosis

Hurlè A., Wangüemert F., Feijóo J. J., Medina A.

From the Department of Cardiovascular Surgery *Cardiology Hospital N. S. del Pino, Las Palmas de Gran Canaria Canary Islands, Spain


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Background. Analyzing the hemo­dy­nam­ics of ­small-­sized tilt­ing-­disc mechan­i­cal pros­the­ses implant­ed in the ­mitral posi­tion.
Methods. Experimental ­design: ­this is a ret­ro­spec­tive ­study. The ­mean fol­low-up of ­patients was 114±27 ­months (­range 68-152 ­months). Setting: depart­ments of Cardiovascular Surgery and Cardiology in a gen­er­al com­mu­nity hos­pi­tal. Patients: ­this ­study ­includes 9 sur­vi­vors of 17 ­patients under­go­ing ­mitral ­valve replace­ment ­with ­this ­type of ­device ­between May, 1982 and July, 1991. Interventions: all sub­jects under­went ­mitral ­valve replace­ment ­with ­size 25 mm Sorin tilt­ing-­disc mechan­i­cal pros­the­ses. Measures: all ­patients under­went trans­tho­rac­ic ech­o­car­di­og­ra­phy. Five con­sent­ing ­patients ­also under­went trans­oe­soph­a­geal ech­o­car­di­og­ra­phy. The fol­low­ing param­e­ters ­were meas­ured: peak gra­di­ent, ­mean gra­di­ent, ­peak veloc­ity, ­mean veloc­ity, pres­sure ­half-­time and Doppler ­area.
Results. The ejec­tion frac­tion was 50% or ­more in all ­patients. The fol­low­ing ­mean ­results ­were ­obtained: peak gra­di­ent: 17.4±2.5 mmHg; mean gra­di­ent: 8.2±0.6 mmHg; peak veloc­ity: 2.1±0.1 m/sec; mean veloc­ity: 1.43±0.06 m/sec; pressure ­half-­time: 135.9±29.7 ­msec; Doppler ­area: 1.7±0.3 cm2.
Conclusions. Valve replace­ment ­with Sorin 25 mm tilt­ing-­disc mechan­i­cal pros­the­ses ­appears to orig­i­nate a mod­er­ate ­degree of ­mitral sten­o­sis and, there­fore, we do not rec­om­mend ­their use if at all pos­sible.

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