Pavie A, Bors V, Piazza C, Desruennes M, Fontanel M, Jault F, Gandjbakhch I, Cabrol C
Department of Cardiovascular Surgery, Hôpital de La Pitié, Paris, France.
J Card Surg. 1988 Sep;3(3 Suppl):353-8. doi: 10.1111/jocs.1988.3.3s.353.
Low profile bioprostheses are particularly useful for certain anatomical conditions. In some patients with rheumatic aortic insufficiency, an important dilatation of the aortic annulus is present, even when the subcoronary aorta is not enlarged. In these cases, the bioimplant heart valve with its low height avoids any threat to the aortic wall or to the coronary ostia. Frequently, the left ventricular cavity is not enlarged in patients with mitral stenosis. The characteristic low profile of this valve avoids left outflow obstruction as well as traumatism of the left ventricular wall. In the tricuspid position, this design is particularly useful because it leaves the right ventricular cavity totally free. From February 1981 to December 1983, 198 bioimplant (LIOTTA) low profile bioprostheses were implanted in 184 patients. There were 63 aortic (AVR), 101 mitral (MVR), 14 mitral and aortic (MAVR), and 6 tricuspid (TVR) valve replacements. Early mortality (30 days) was 6% (AVR = 1.6%; MVR = 8.9%; MAVR = 7.1%; TVR = 0). The 181 survivors were followed over a period of 3-84 months (643 patient-years). The thromboembolic complication rate was low (0.7%/patient-year) and 96.9% +/- 1.4% of patients were free of thromboembolism (AVR = 98.2% +/- 1.7%; MVR = 97.6% +/- 1.7%). Five years after implant, 91.7% +/- 3.2% of patients were free of valve failure (AVR = 93.7% +/- 4.4%; MVR = 88.8% +/- 5.2%). Actuarial analysis shows an expected survival at 5 years (average) of 87.2% +/- 3.4% (AVR = 87.4% +/- 6%; MVR = 87.3% +/- 4%) with an actuarial rate of freedom from reoperation of 87.5% +/- 3.5%).(ABSTRACT TRUNCATED AT 250 WORDS)
