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PubMed · 7045133

Continuous suture technique in prosthetic aortic valve replacement.

E Hjelms·R Vilhelmsen·I H Rygg
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Abstract

Among 80 patients having aortic valve replacement using a continuous suture technique the occurrence of periprosthetic leak was 8.8%. There is a statistically significant difference in the occurrence of the periprosthetic leak in patients having pure stenosis (o) of combined stenosis and insufficiency, and patients having pure insufficiency (26%). Continuous suture technique reduces cross clamp time and by-pass time significantly but should be used routinely only in stenotic lesions. In pure insufficiency the method of suture should be considered separately in each case. Interrupted suture technique should be used if one or more of the known factors predisposing to perivalvular leak are present.

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BioprosthesisFollow-Up StudiesHeart Valve ProsthesisHumansPostoperative ComplicationsSuture TechniquesTime FactorsJournal Article

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E Hjelms, R Vilhelmsen, I H Rygg. Continuous suture technique in prosthetic aortic valve replacement.. https://pubmed.ncbi.nlm.nih.gov/7045133/

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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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