Clinical and hemodynamic comparisons of Kay-Shiley, Starr-Edwards No. 6520, and Reis-Hancock porcine xenograft mitral valves

John Brown, P. David Myerowitz, Michael S. Cann, Stephen B. Colvin, Charles L. McIntosh, Andrew G. Morrow

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Mitral valve replacement (MVR) in a patient with a small or normal-size left ventricle necessitates the use of a low-profile prosthesis or a porcine xenograft. This retrospective study summarizes the clinical and hemodynamic findings in 88 patients in whom such valves were implanted. Isolated MVR was performed in 74 patients and MVR plus tricuspid valve replacement with the same type of prosthesis in 14 patients. Preoperative hemodynamic findings and the number of patients in each group were comparable. Early (<30 days) and 6 month mortality rates were Kay-Shiley (KS) 33 and 48 percent, Starr-Edwards No. 6520 (SE) 14 and 25 percent, porcine xenografts (P) 6 and 12 percent. The incidence of fatal postoperative arrhythmias was 11 percent with KS valves, 11 percent with SE valves, and 6 percent with P valves. Postoperative thromboembolic complications occurred in 33 percent of patients with KS valves, 28 percent with SE valves, but were not observed in any patient with a P valve. The hemodynamic performance of all three valve types was similar as measured at postoperative catheterization; the calculated orifice areas and diastolic gradients were not significantly different in the three groups. However, the significantly lower early mortality rate and the absence of thromboembolic complications make the porcine xenograft a superior choice for patients with normal or small-size left ventricles.

Original languageEnglish (US)
Pages (from-to)983-991
Number of pages9
JournalSurgery
Volume76
Issue number6
StatePublished - 1974
Externally publishedYes

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Mitral Valve
Heterografts
Swine
Hemodynamics
Prostheses and Implants
Heart Ventricles
Tricuspid Valve
Mortality
Catheterization
Cardiac Arrhythmias
Retrospective Studies
Incidence

ASJC Scopus subject areas

  • Surgery

Cite this

Brown, J., Myerowitz, P. D., Cann, M. S., Colvin, S. B., McIntosh, C. L., & Morrow, A. G. (1974). Clinical and hemodynamic comparisons of Kay-Shiley, Starr-Edwards No. 6520, and Reis-Hancock porcine xenograft mitral valves. Surgery, 76(6), 983-991.

Clinical and hemodynamic comparisons of Kay-Shiley, Starr-Edwards No. 6520, and Reis-Hancock porcine xenograft mitral valves. / Brown, John; Myerowitz, P. David; Cann, Michael S.; Colvin, Stephen B.; McIntosh, Charles L.; Morrow, Andrew G.

In: Surgery, Vol. 76, No. 6, 1974, p. 983-991.

Research output: Contribution to journalArticle

Brown, J, Myerowitz, PD, Cann, MS, Colvin, SB, McIntosh, CL & Morrow, AG 1974, 'Clinical and hemodynamic comparisons of Kay-Shiley, Starr-Edwards No. 6520, and Reis-Hancock porcine xenograft mitral valves', Surgery, vol. 76, no. 6, pp. 983-991.
Brown, John ; Myerowitz, P. David ; Cann, Michael S. ; Colvin, Stephen B. ; McIntosh, Charles L. ; Morrow, Andrew G. / Clinical and hemodynamic comparisons of Kay-Shiley, Starr-Edwards No. 6520, and Reis-Hancock porcine xenograft mitral valves. In: Surgery. 1974 ; Vol. 76, No. 6. pp. 983-991.
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N2 - Mitral valve replacement (MVR) in a patient with a small or normal-size left ventricle necessitates the use of a low-profile prosthesis or a porcine xenograft. This retrospective study summarizes the clinical and hemodynamic findings in 88 patients in whom such valves were implanted. Isolated MVR was performed in 74 patients and MVR plus tricuspid valve replacement with the same type of prosthesis in 14 patients. Preoperative hemodynamic findings and the number of patients in each group were comparable. Early (<30 days) and 6 month mortality rates were Kay-Shiley (KS) 33 and 48 percent, Starr-Edwards No. 6520 (SE) 14 and 25 percent, porcine xenografts (P) 6 and 12 percent. The incidence of fatal postoperative arrhythmias was 11 percent with KS valves, 11 percent with SE valves, and 6 percent with P valves. Postoperative thromboembolic complications occurred in 33 percent of patients with KS valves, 28 percent with SE valves, but were not observed in any patient with a P valve. The hemodynamic performance of all three valve types was similar as measured at postoperative catheterization; the calculated orifice areas and diastolic gradients were not significantly different in the three groups. However, the significantly lower early mortality rate and the absence of thromboembolic complications make the porcine xenograft a superior choice for patients with normal or small-size left ventricles.

AB - Mitral valve replacement (MVR) in a patient with a small or normal-size left ventricle necessitates the use of a low-profile prosthesis or a porcine xenograft. This retrospective study summarizes the clinical and hemodynamic findings in 88 patients in whom such valves were implanted. Isolated MVR was performed in 74 patients and MVR plus tricuspid valve replacement with the same type of prosthesis in 14 patients. Preoperative hemodynamic findings and the number of patients in each group were comparable. Early (<30 days) and 6 month mortality rates were Kay-Shiley (KS) 33 and 48 percent, Starr-Edwards No. 6520 (SE) 14 and 25 percent, porcine xenografts (P) 6 and 12 percent. The incidence of fatal postoperative arrhythmias was 11 percent with KS valves, 11 percent with SE valves, and 6 percent with P valves. Postoperative thromboembolic complications occurred in 33 percent of patients with KS valves, 28 percent with SE valves, but were not observed in any patient with a P valve. The hemodynamic performance of all three valve types was similar as measured at postoperative catheterization; the calculated orifice areas and diastolic gradients were not significantly different in the three groups. However, the significantly lower early mortality rate and the absence of thromboembolic complications make the porcine xenograft a superior choice for patients with normal or small-size left ventricles.

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