TY - JOUR
T1 - Aortic valve replacement
T2 - a ten-year follow-up of non-cloth-covered vs cloth-covered caged-ball prostheses
AU - Starr, A.
AU - Grunkemeier, G. L.
AU - Lambert, L. E.
AU - Thomas, D. R.
AU - Sugimura, S.
AU - Lefrak, E. A.
PY - 1977
Y1 - 1977
N2 - From 1965 to 1976, 721 isolated aortic valve replacements were performed at the University of Oregon hospitals, utilizing Starr-Edwards caged-ball prostheses. Three models of aortic prostheses were introduced during this period: a non-cloth-covered model has been in continuous use since 1965; a cloth-covered model was begun in 1968 and has been supplanted by the modified composite-strut or 'track' model since 1972. The 5-yr actuarial survival rate for operative survivors is about 80% for both non-cloth-covered and cloth-covered valves, while the 10-yr survival is 61%, based on the older model only. The actuarially-determined percentages of patients experiencing significant thromboembolic episodes (i.e., all except transient ischemic episodes) at 5 yrs are 7% for the cloth-covered and 9% for the non-cloth-covered model. If transient ischemic attacks are included, the cloth-covered model has only an 8% incidence at 5-yr compared to a 22% incidence for the older model. However, the cloth-covered valves are subject to a higher risk of reoperation because of the possibility of cloth injury. The 'track' valve, therefore, was designed with exposed metal on the inner surface of each strut to prevent ball-cloth contact. In 107 patients (mean followup period 1 yr) receiving anticoagulation, this prosthesis has maintained the same low incidence of thromboembolism as the previous cloth-covered model, with no reoperations for valve failure.
AB - From 1965 to 1976, 721 isolated aortic valve replacements were performed at the University of Oregon hospitals, utilizing Starr-Edwards caged-ball prostheses. Three models of aortic prostheses were introduced during this period: a non-cloth-covered model has been in continuous use since 1965; a cloth-covered model was begun in 1968 and has been supplanted by the modified composite-strut or 'track' model since 1972. The 5-yr actuarial survival rate for operative survivors is about 80% for both non-cloth-covered and cloth-covered valves, while the 10-yr survival is 61%, based on the older model only. The actuarially-determined percentages of patients experiencing significant thromboembolic episodes (i.e., all except transient ischemic episodes) at 5 yrs are 7% for the cloth-covered and 9% for the non-cloth-covered model. If transient ischemic attacks are included, the cloth-covered model has only an 8% incidence at 5-yr compared to a 22% incidence for the older model. However, the cloth-covered valves are subject to a higher risk of reoperation because of the possibility of cloth injury. The 'track' valve, therefore, was designed with exposed metal on the inner surface of each strut to prevent ball-cloth contact. In 107 patients (mean followup period 1 yr) receiving anticoagulation, this prosthesis has maintained the same low incidence of thromboembolism as the previous cloth-covered model, with no reoperations for valve failure.
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M3 - Article
C2 - 884817
AN - SCOPUS:0017584755
SN - 0009-7322
VL - 56
SP - 133
EP - 139
JO - Circulation
JF - Circulation
IS - 3 suppl. 2
ER -