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. 1980 Jun;7(2):137–148.

Ionescu-Shiley pericardial xenograft valve: Hemodynamic evaluation and early clinical follow-up of 326 patients

David A Ott 1, Aldemire T Coelho 1, Denton A Cooley 1, George J Reul Jr 1
PMCID: PMC287845  PMID: 15216265

Abstract

Dissatisfaction with the hemodynamic characteristics of available porcine valves prompted a clinical trial of the Ionescu-Shiley percardial xenograft (ISPX) valve. Three hundred fifty-six ISPX valves were implanted consecutively in 326 patients. Operative mortality was 2.6% (2/75) for aortic valve replacement alone and 7.7% (12/155) for aortic valve replacements that included reoperations and combined procedures such as mitral commissurotomy, annuloplasty, and coronary artery bypass. Operative mortality for all patients who underwent mitral valve replacement was 9.5% (14/147). The mean peak systolic gradient pressure in the aortic position was 5.4 mm Hg overall and 4.27 mm Hg with the size 19 mm valve. There were no embolic episodes in patients who received the ISPX valve in the aortic position. The available data indicate that the rate of peripheral embolism with the ISPX valve compares favorably with that of porcine valves. Considering its hemodynamic advantage, if the longterm durability of the full-orifice Ionescu-Shiley pericardial xenograft valve continues to be confirmed by follow-up studies, it is our opinion that it is the biologic valve of choice.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barnhorst D. A., Oxman H. A., Connolly D. C., Pluth J. R., Danielson G. K., Wallace R. B., McGoon D. C. Long-term follow-up of isolated replacement of the aortic or mitral valve with the Starr-Edwards prosthesis. Am J Cardiol. 1975 Feb;35(2):228–233. doi: 10.1016/0002-9149(75)90006-5. [DOI] [PubMed] [Google Scholar]
  2. Bonchek L. I., Starr A. Ball valve prostheses: current appraisal of late results. Am J Cardiol. 1975 Jun;35(6):843–854. doi: 10.1016/0002-9149(75)90121-6. [DOI] [PubMed] [Google Scholar]
  3. Bristow J. D., Kremkau E. L. Hemodynamic changes after valve replacement with Starr-Edwards prostheses. Am J Cardiol. 1975 May;35(5):716–724. doi: 10.1016/0002-9149(75)90064-8. [DOI] [PubMed] [Google Scholar]
  4. Cooley D. A., Okies J. E., Wukasch D. C., Sandiford F. M., Hallmann G. L. Ten-year experience with cardiac valve replacement: results with a new mitral prosthesis. Ann Surg. 1973 Jun;177(6):818–826. doi: 10.1097/00000658-197306000-00023. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Gabbay S., McQueen D. M., Yellin E. L., Becker R. M., Frater R. W. In vitro hydrodynamic comparison of mitral valve prostheses at high flow rates. J Thorac Cardiovasc Surg. 1978 Dec;76(6):771–787. [PubMed] [Google Scholar]
  6. Gabbay S., McQueen D. M., Yellin E. L., Frater R. W. In vitro hydrodynamic comparison of mitral valve bioprostheses. Circulation. 1979 Aug;60(2 Pt 2):62–70. doi: 10.1161/01.cir.60.2.62. [DOI] [PubMed] [Google Scholar]
  7. Geha A. S., Laks H., Stansel H. C., Jr, Cornhill J. F., Kilman J. W., Buckley M. J., Roberts W. C. Late failure of porcine valve heterografts in children. J Thorac Cardiovasc Surg. 1979 Sep;78(3):351–364. [PubMed] [Google Scholar]
  8. Horowitz M. S., Goodman D. J., Fogarty T. J., Harrison D. C. Mitral valve replacement with the glutaraldehyde-preserved porcine heterograft. Clinical, hemodynamic, and pathological correlations. J Thorac Cardiovasc Surg. 1974 Jun;67(6):885–895. [PubMed] [Google Scholar]
  9. Ionescu M. I., Tandon A. P. Long term clinical and haemodynamic evaluation of the Ionescu-Shiley pericardial xenograft heart valve. Thoraxchir Vask Chir. 1978 Aug;26(4):250–258. doi: 10.1055/s-0028-1096633. [DOI] [PubMed] [Google Scholar]
  10. Ionescu M. I., Tandon A. P., Mary D. A., Abid A. Heart valve replacement with the Ionescu-Shiley pericardial xenograft. J Thorac Cardiovasc Surg. 1977 Jan;73(1):31–42. [PubMed] [Google Scholar]
  11. Jones E. L., Craver J. M., Morris D. C., King S. B., 3rd, Douglas J. S., Jr, Franch R. H., Hatcher C. R., Jr, Morgan E. A. Hemodynamic and clinical evaluation of the Hancock xenograft bioprosthesis of aortic valve replacement (with emphasis on management of the small aortic root). J Thorac Cardiovasc Surg. 1978 Feb;75(2):300–308. [PubMed] [Google Scholar]
  12. Klint R., Hernandez A., Weldon C., Hartmann A. F., Jr, Goldring D. Replacement of cardiac valves in children. J Pediatr. 1972 Jun;80(6):980–987. doi: 10.1016/s0022-3476(72)80011-8. [DOI] [PubMed] [Google Scholar]
  13. Mehlman D. J., Resnekov L. A guide to the radiographic identification of prosthetic heart valves. Circulation. 1978 Mar;57(3):613–623. doi: 10.1161/01.cir.57.3.613. [DOI] [PubMed] [Google Scholar]
  14. Moreno-Cabral R. J., McNamara J. J., Mamiya R. T., Brainard S. C., Chung G. K. Acute thrombotic obstruction with Björk-Shiley valves: diagnostic and surgical considerations. J Thorac Cardiovasc Surg. 1978 Mar;75(3):321–330. [PubMed] [Google Scholar]
  15. Morris D. C., King S. B., Douglas J. S., Jr, Wickliffe C. W., Jones E. L. Hemodynamic results of aortic valvular replacement with the porcine xenograft valve. Circulation. 1977 Nov;56(5):841–844. doi: 10.1161/01.cir.56.5.841. [DOI] [PubMed] [Google Scholar]
  16. Ott D. A., Cooley D. A. Current status of cardiac valve surgery. J Fla Med Assoc. 1979 Oct;66(10):1034–1038. [PubMed] [Google Scholar]
  17. Pipkin R. D., Buch W. S., Fogarty T. J. Evaluation of aortic valve replacement with a porcine xenograft without long-term anticoagulation. J Thorac Cardiovasc Surg. 1976 Feb;71(2):179–186. [PubMed] [Google Scholar]
  18. Roberts W. C. Choosing a substitute cardiac valve: type, size, surgeon. Am J Cardiol. 1976 Nov 4;38(5):633–644. doi: 10.1016/s0002-9149(76)80014-8. [DOI] [PubMed] [Google Scholar]
  19. Stinson E. B., Griepp R. B., Oyer P. E., Shumway N. E. Long-term experience with porcine aortic valve xenografts. J Thorac Cardiovasc Surg. 1977 Jan;73(1):54–63. [PubMed] [Google Scholar]
  20. Stinson E. B., Griepp R. B., Shumway N. E. Clinical experience with a porcine aortic valve xenograft for mitral valve replacement. Ann Thorac Surg. 1974 Oct;18(4):391–401. doi: 10.1016/s0003-4975(10)64376-7. [DOI] [PubMed] [Google Scholar]
  21. Tandon A. P., Sengupta S. M., Lukacs L., Ionescu M. I. Long-term clinical and hemodynamic evaluation of the Ionescu-Schiley pericardial xenograft and the Braunwald-Cutter and Björk-Shiley prostheses in the mitral position. J Thorac Cardiovasc Surg. 1978 Dec;76(6):763–770. [PubMed] [Google Scholar]
  22. Tandon A. P., Smith D. R., Ionescu M. I. Hemodynamic evaluation of the Ionescu-Shiley pericardial xenograft in the mitral position. Am Heart J. 1978 May;95(5):595–601. doi: 10.1016/0002-8703(78)90301-0. [DOI] [PubMed] [Google Scholar]
  23. Tandon A. P., Smith D. R., Mary D. A., Ionescu M. I. Sequential hemodynamic studies in patients having aortic valve replacement with the Ionescu-Shiley pericardial xenograft. Ann Thorac Surg. 1977 Aug;24(2):149–155. doi: 10.1016/s0003-4975(10)63724-1. [DOI] [PubMed] [Google Scholar]
  24. Tandon A. P., Smith D. R., Whitaker W., Ionescu M. I. Long-term haemodynamic evaluation of aortic pericardial xenograft. Br Heart J. 1978 Jun;40(6):602–607. doi: 10.1136/hrt.40.6.602. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Tandon Anand P., Smith Donald R., Ionescu Marian I. SEQUENTIAL HEMODYNAMIC STUDIES OF THE IONESCU-SHILEY PERICARDIAL XENOGRAFT VALVE UP TO SIX YEARS AFTER IMPLANTATION. Cardiovasc Dis. 1979 Sep;6(3):271–282. [PMC free article] [PubMed] [Google Scholar]
  26. Wright J. T. A pulsatile flow study comparing the Hancock porcine xenograft aortic valve prostheses models 242 and 250. Med Instrum. 1977 Mar-Apr;11(2):114–117. [PubMed] [Google Scholar]
  27. Wukasch D. C., Sandiford F. M., Reul G. J., Jr, Hallman G. L., Cooley D. A. Complications of cloth-covered prosthetic valves: results with a new mitral prosthesis. J Thorac Cardiovasc Surg. 1975 Jan;69(1):107–116. [PubMed] [Google Scholar]

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