Aj. Berrebi et al., Results of up to 9 years of high-temperature-fixed valvular bioprostheses in a young population, ANN THORAC, 71(5), 2001, pp. S353-S355
Citations number
12
Categorie Soggetti
Cardiovascular & Respiratory Systems","Medical Research Diagnosis & Treatment
Background. Bioprosthetic valve replacement in young patients remains a con
troversial issue due to a high rate of early calcification. Previous studie
s in our laboratory have shown that high-temperature fixation of glutaralde
hyde preserved bioprosthesis (HTF) mitigates calcification. The first clini
cal application of this technique was started in 1991.
Methods. From January 1991 to September 1998, 50 patients in whom anticoagu
lants were contraindicated underwent single aortic valve replacement (n = 3
3) or mitral valve replacement (n = 17) using HTF bioprostheses. The age of
the patients ranged from 7 months to 35 years (mean 22.7 +/- 6.8 years). T
he mean New York Heart Association status was 2.4. Mean follow-up 4 years /- 1.8 for a total follow-up of 196 patient-years.
Results. There were no operative deaths and but there were two late deaths,
one valve related. Structural failure occured in 4 patients (2%/patient-ye
ar) requiring a reoperation in 3 patients (1.59%/patient-year). No endocard
itis or thromboembolic episodes were observed. At late examination (Tune 20
00), 46 patients (92%) were in New York Heart Association class I or II, wi
th a well functioning valve.
Conclusions. Replacement with HTF bioprostheses in young patients has demon
strated encouraging midterm results with a low incidence of structural fail
ure (C) 2001 by The Society of Thoracic Surgeons.