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PubMed · 3047134

A modified technique for mitral valve replacement.

J L Mercer·T K Kaul
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Abstract

Between 1976 and 1983 254 mitral valve prostheses (243 Björk-Shiley and 14 bioprostheses) were implanted in 252 patients using a modified technique. The age of patients varied from 26-72 years (mean 56 +/- 18 years). This technique allows an equidistant placement of sutures and accurate stitching of mitral valve annulus to the prosthetic valve ring. Follow-up averaged 67 +/- 21.6 months (3-7 years). Linearized aseptic dehiscence was 0.17 per 100 patient years. This technique was especially useful in patients with small left atrium and minimised the risk of a major prosthetic detachment.

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BioprosthesisHeart Valve ProsthesisHumansMiddle AgedMitral ValveProsthesis DesignReoperationSuture TechniquesJournal Article

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J L Mercer, T K Kaul. A modified technique for mitral valve replacement.. https://pubmed.ncbi.nlm.nih.gov/3047134/

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Early outcomes of tricuspid valve replacement in young children.

BACKGROUND: Early outcomes after tricuspid valve replacement in young children are ill defined. The experience of the Pediatric Cardiac Care Consortium (45 centers, 1984 to 2002) was reviewed to evaluate the results of tricuspid valve replacement in children <6 years of age. METHODS AND RESULTS: Ninety-seven patients who underwent initial tricuspid valve replacement are included in the present analysis. The most frequent cardiac diagnoses were Ebstein's anomaly (40%), pulmonary atresia (11%), and tetralogy of Fallot (8%). Age at tricuspid valve replacement was 2.9+/-1.7 years (mean+/-SD). Mean patient weight was 12.7+/-6.1 kg. The major outcome was survival to discharge. Associations among age, diagnosis, valve type/size, and outcome were evaluated through the use of chi2 analysis and logistic regression model fitting approaches. Hospital mortality was 26% and was very high (64%) in patients <1 year of age. A large size-to-weight ratio was the strongest predictor of mortality based on multivariable analysis (P<0.001). Mortality was 54% for patients with a size-to-weight ratio >2.5. Other complications included heart block requiring a pacemaker (13%) and thrombosis (5%). Pacemaker implantation was associated with the use of a mechanical valve (23% versus 6% bioprosthetic valve; P=0.01) CONCLUSIONS: Tricuspid valve replacement in young children is associated with high mortality, especially in infants <1 year of age. Surgical options other than tricuspid valve replacement such as transplantation may need to be considered in infants.

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