TY - JOUR
T1 - Late Complications of Aortic Valve Replacement with Cloth-Covered, Composite-Seat Prostheses
T2 - A Six-Year Appraisal
AU - Starr, Albert
AU - Bonchek, Lawrence I.
AU - Anderson, Richard P.
AU - Wood, James A.
AU - Chapman, Richard D.
N1 - Funding Information:
From the Division of Cardiopulmonary Surgery, University of Oregon Medical School, Portland, Ore. Supported by US. Public Health Service Grant No. HL 16461. This article, accepted for publication Nov. 5, 1974, is an expanded and updated version of a presentation at the Tenth Anniversary Meeting of The Society of Thoracic Surgeons, Los Angeles, Calif., Jan. 28-30, 1974. We would like to thank Louis E. Lambert, M.S., and Gary L. Grunkemeier, Ph.D., for their assistance in collation and analysis of data. Address reprint requests to Dr. Starr, Division of Cardiopulmonary Surgery, University of Oregon Medical School, 3181 S.W. Sam Jackson Park Rd., Portland, Ore. 97201.
PY - 1975
Y1 - 1975
N2 - Advanced actuarial techniques are used to analyze early and late results in a closely followed series of 396 patients who received a cloth-covered, composite-seat aortic prosthesis. Late mortality and various complications are carefully assessed, and most late deaths are seen to be unrelated to the prosthesis. One hundred sixteen patients with Model 2310–2320 prostheses who received warfarin postoperatively had no thromboembolic complications in 360 patient-years of follow-up (average, 3.1 years per patient); 134 patients who had the same prosthesis but did not receive warfarin had 9 emboli per 100 patient-years (average follow-up, 1.7 years per patient; total, 228 patient-years). By comparison, in 9 years' experience with non-cloth-covered Model 1200–1260 valves, 132 patients had 4.0 emboli per 100 patient-years (average follow-up, 5.1 years; total, 673 patient-years). The safety of cloth-covered valves is clearly enhanced by concomitant use of anticoagulants; the possibility that antiplatelet drugs may suffice has not yet been demonstrated. Strut cloth wear was found at reoperation in 10 patients. The Model 2400 composite strut (“track”) valve with a narrow metal track on the inner surface of each strut prevents this complication.
AB - Advanced actuarial techniques are used to analyze early and late results in a closely followed series of 396 patients who received a cloth-covered, composite-seat aortic prosthesis. Late mortality and various complications are carefully assessed, and most late deaths are seen to be unrelated to the prosthesis. One hundred sixteen patients with Model 2310–2320 prostheses who received warfarin postoperatively had no thromboembolic complications in 360 patient-years of follow-up (average, 3.1 years per patient); 134 patients who had the same prosthesis but did not receive warfarin had 9 emboli per 100 patient-years (average follow-up, 1.7 years per patient; total, 228 patient-years). By comparison, in 9 years' experience with non-cloth-covered Model 1200–1260 valves, 132 patients had 4.0 emboli per 100 patient-years (average follow-up, 5.1 years; total, 673 patient-years). The safety of cloth-covered valves is clearly enhanced by concomitant use of anticoagulants; the possibility that antiplatelet drugs may suffice has not yet been demonstrated. Strut cloth wear was found at reoperation in 10 patients. The Model 2400 composite strut (“track”) valve with a narrow metal track on the inner surface of each strut prevents this complication.
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U2 - 10.1016/S0003-4975(10)64019-2
DO - 10.1016/S0003-4975(10)64019-2
M3 - Article
C2 - 1119883
AN - SCOPUS:0016638943
SN - 0003-4975
VL - 19
SP - 289
EP - 300
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 3
ER -