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Biomedical subjects

H Tutassaura

Publications and source records attributed to H Tutassaura.

At least 19 recordsLinked to original sources
PubMed1992

Structural valve deterioration in elderly patient populations with the Carpentier-Edwards standard and supra-annular porcine bioprostheses: a comparative study.

From 1975 to 1989, over 1400 patients in the elderly population and over 1700 patients under 65 years of age received the Carpentier-Edwards standard (CE-Standard) and supra-annular porcine (CE-SAV) bioprotheses. The mean ages of the patients receiving the two protheses within the three subgroups of the elderly population-65-69 years, 70-79 years, and 80 years and over-were relatively similar. There was no statistically significant difference in the performance of the prostheses regarding structural valve deterioration (SVD) at seven years. The freedom from SVD for aortic valve replacement in the 65-69 years group at seven years was 98.7% +/- 1.3% for the CE-Standard and 98.7% +/- 1.0% for the CE-SAV, for both the 70-79 years group and the 80 years and over group the figure was 100% for both prostheses (p = NS). The freedom from SVD after mitral valve replacement in the 65-69 years group at seven years was 90.0% +/- 4.3% for the CE-Standard and 84.8% +/- 7.5% for the CE-SAV, for the 70-79 years group it was 95.3% +/- 3.2% and 95.5% +/- 3.6% respectively and for the 80 years and over group the figure was 100% for both prostheses (p = NS within groups). The long term freedom from SVD after aortic valve replacement was 98.4% +/- 3% at 15 years for the CE-Standard in the 65-69 years group, 94.9% +/- 5% at 13 years for the 70-79 years group and 100% at 13 years for the 80 years and over group.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Distribution↗
PubMed1991

The Carpentier-Edwards standard porcine bioprosthesis: clinical performance to 15 years.

The Carpentier-Edwards standard porcine bioprosthesis was implanted in 1,195 patients in 1,213 operative procedures between 1975 and 1987, with the majority of implants performed prior to 1982 at the University of British Columbia. The mean age of the patient population was 57.2 years (range 8 to 85 years). The mean follow-up was 7.4 years per patient. The freedom from the combination of thromboembolism and antithromboembolic therapy-related hemorrhage at 15 years was 79.5% for aortic valve replacement (AVR), 72% for mitral valve replacement (MVR), and 84% for multiple valve replacement (MR) (p less than 0.05, AVR greater than MR greater than MVR). The freedom from structural valve deterioration at 15 years was 71% for AVR, 41% for MVR, and 41% for MR (14 years) (p less than 0.05, AVR greater than MVR greater than MR). The freedom from nonstructural dysfunction and prosthetic valve endocarditis did not distinguish the valve positions (p = NS). The freedom from valve-related mortality from all causes including reoperation was 92% for AVR, 78% for MVR, and 77% for MR at 15 years (p less than 0.05, AVR greater than MVR greater than MR). The freedom from residual morbidity was not significantly different between valve positions (p = NS). The freedom from treatment failure (valve-related mortality and residual morbidity) at 15 years was 87% for AVR, 72% for MVR, and 75% for MR (p less than 0.05, AVR greater than MR greater than MVR). The freedom from all complications at 14 years was 50% for AVR, 25% for MVR, and 27% for MR (p less than 0.05, AVR greater than MR greater than MVR).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

The Carpentier-Edwards supra-annular porcine bioprosthesis: clinical performance to 8 years of a new generation porcine bioprosthesis.

The Carpentier-Edwards supra-annular porcine bioprosthesis has been utilized at the University of British Columbia since its introduction in 1982. The prosthesis was designed to improve hemodynamics with the supra-annular configuration and to reduce tissue failure with low-pressure glutaraldehyde preservation of the porcine aortic tissue. The prosthesis was inserted in 1,956 patients with 2,129 prostheses between 1982 and 1989. The mean age of the patient population was 62.7 years (range 13 to 87 years). The mean follow-up was 3.7 years per patient. The freedom from thromboembolism and antithromboembolic therapy-related hemorrhage at 8 years was 92% for aortic valve replacement (AVR), 83% for mitral valve replacement (MVR), and 92% for multiple valve replacement (MR) (p less than 0.05, AVR greater than MR greater than MVR). The freedom from structural valve deterioration was 86% for AVR, 73% for MVR, and 96% for MR at 8 years (p less than 0.05, AVR greater than MR greater than MVR). The freedom from nonstructural valve dysfunction and prosthetic valve endocarditis was not different between positions (p = NS). The freedom from valve-related mortality at 8 years was 98% for AVR, 94% for MVR, and 98% for MR (p less than 0.05, AVR greater than MR greater than MVR). The freedom from residual morbidity was not different at 8 years (p = NS). The freedom from treatment failure (valve-related mortality and residual morbidity) was 96% for AVR, 89% for MVR, and 94% for MR (p less than 0.05, AVR greater than MVR greater than MR).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Age as a determinant for selection of porcine bioprostheses for cardiac valve replacement: experience with Carpentier-Edwards standard bioprosthesis.

Almost exclusive use of Carpentier-Edwards porcine bioprostheses for cardiac valve replacement in 1194 patients between 1975 and 1987 at the authors' institutions has afforded the opportunity for a more scientific basis for prosthesis selection for subsets of patients, with regard to age and valve-related complications. The present study, performed according to previously established guidelines, investigated the influence of patient age and valve position as determinants of durability of 1315 porcine implants in terms of the following valve-related complications: structural valve deterioration, nonstructural dysfunction, thromboembolism, antithromboembolic therapy-related hemorrhage and prosthetic valve endocarditis. Age groups were as follows: 35 years and younger, 36 to 50 years, 51 to 65 years, and 66 years or older. Thromboembolism was found to be less common in the younger age groups, and significantly less common in patients following aortic compared to mitral valve replacement. The age group assessment for antithromboembolic therapy-related hemorrhage, nonstructural dysfunction and prosthetic valve endocarditis revealed no difference between positions or age groups. Patient age was found to be the major predictor of, and inversely related to, structural valve deterioration. In addition, porcine bioprostheses in the aortic position were shown to have durability superior to that of similar valves in the mitral position. Structural valve deterioration has very little influence on valve-related mortality and residual morbidity. This study thus supports the implantation of porcine bioprostheses in somewhat younger patients than would be advisable for mitral prostheses. The authors now recommend the selective implantation of porcine bioprostheses in the aortic position in patients over 65 years of age, and in the mitral position in patients over 70 years of age.

Adolescent↗
PubMed1990

Malignant primary cardiac tumour presenting as superior vena cava obstruction syndrome.

A 71-year-old male with a malignant primary cardiac lymphoma nearly filling the right atrium presented with symptoms of obstruction of the tricuspid valve and inflow to the right atrium. The tumour was resected as fully as possible; however, a portion of the tumour that had invaded the inferior aspect of the right atrium and the atrioventricular groove could not be excised. Eighteen months after initial presentation, the patient is well and the tumour has not recurred. This is the first case of symptom-free survival of primary cardiac lymphoma for as long as 18 months.

Aged↗
PubMed1976

Mucoid degeneration of the mitral valve. Clinical review, surgical management, and results.

Forty-four patients exhibiting myxomatous degeneration of the mitral valve were reviewed. The clinical features, pathologic findings of the valve excised, surgical treatment, and results are presented. The complexity of the clinical pathologic findings are discussed. Despite the technical difficulties encountered in the surgical treatment of myxomatous degeneration of the mitral valve, the long-term surgical results are excellent.

Adolescent↗
PubMed1972

Assisted circulation following myocardial infarction: a review of 25 patients treated before 1971.

Twenty-five patients with impending death from myocardial infarction were treated with assisted circulation. Of these, 19 had suffered cardiac arrest from which they could not be resuscitated and six were in severe, intractable and expectedly terminal cardiogenic shock.All patients were treated by venoarterial bypass employing a bubble oxygenator. Assistance was continued for an average duration of one hour and 45 minutes at a flow rate between two and four litres per minute. The patients all showed improved cerebral, pulmonary and renal function and acid-base values returned to normal.Five patients survived for at least one month and two were improved; hence 28% of these otherwise terminal patients were helped by this technique of assisted circulation.

Adult↗