Abstract
The major cause of late mortality and morbidity after prosthetic valve replacement is thromboembolism. The nidus for initiation of thrombus formation has been blood metal interfaces, and a new valve--the St Jude prosthesis--has therefore been developed without any metal components. We have assessed echocardiographically in 27 patients the effects of this valve on left ventricular filling characteristics when inserted in the mitral position and compared the findings with those in patients having mitral valve replacement with Starr-Edwards or Björk-Shiley prostheses and with those in patients undergoing repair of the native mitral valve. Echocardiograms were recorded and digitised. Measurements were made of the peak rate of increase of dimension (dD/dt) and duration of rapid filling. Values for the St Jude valve were 13.2 +/- 3.4 cm/s and 160 +/- 40 ms, respectively. The peak rate of dD/dt increase was significantly greater than with either the Björk-Shiley valve or the Starr-Edwards valve and was comparable with findings in mitral valve repair. The duration of the rapid filling phase was not significantly different from control values but was less than that of the Starr-Edwards valve. This study indicates that the new St Jude medical valve is less obstructive than either the Björk-Shiley or Starr-Edwards prostheses. This together with its low thrombogenicity suggests that further trials of this new valve should be undertaken.
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Selected References
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- Björk V. O. A new tilting disc valve prosthesis. Scand J Thorac Cardiovasc Surg. 1969;3(1):1–10. doi: 10.3109/14017436909131912. [DOI] [PubMed] [Google Scholar]
- Björk V. O., Henze A. Ten years' experience with the Björk-Shiley tilting disc valve. J Thorac Cardiovasc Surg. 1979 Sep;78(3):331–342. [PubMed] [Google Scholar]
- Björk V. O., Holmgren A., Olin C., Ovenfors C. O. Clinical and haemodynamic results of aortic valve replacement with the Björk-Shiley tilting disc valve prosthesis. Scand J Thorac Cardiovasc Surg. 1971;5(3):177–191. [PubMed] [Google Scholar]
- 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]
- Braunwald N. S., Detmer D. E. A critical analysis of the status of prosthetic valves and homografts. Prog Cardiovasc Dis. 1968 Sep;11(2):113–132. doi: 10.1016/0033-0620(68)90022-4. [DOI] [PubMed] [Google Scholar]
- Emery R. W., Mettler E., Nicoloff D. M. A new cardiac prosthesis: the St. Jude Medical cardiac valve: in vivo results. Circulation. 1979 Aug;60(2 Pt 2):48–54. doi: 10.1161/01.cir.60.2.48. [DOI] [PubMed] [Google Scholar]
- Emery R. W., Nicoloff D. M. St. Jude Medical cardiac valve prosthesis: in vitro studies. J Thorac Cardiovasc Surg. 1979 Aug;78(2):269–276. [PubMed] [Google Scholar]
- Gibson D. G., Brown D. J. Measurement of peak rates of left ventricular wall movement in man. Comparison of echocardiography with angiography. Br Heart J. 1975 Jul;37(7):677–683. doi: 10.1136/hrt.37.7.677. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gibson D. G., Brown D. Measurement of instantaneous left ventricular dimension and filling rate in man, using echocardiography. Br Heart J. 1973 Nov;35(11):1141–1149. doi: 10.1136/hrt.35.11.1141. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lee M. E., Murakami T., Stanczewski B., Parmeggiani A., Srinivasan S., Sawyer P. N. Etiology of thrombus formation on prosthetic metal heart valves. The role of spontaneous in vivo interfacial potentials and their measurements. J Thorac Cardiovasc Surg. 1972 May;63(5):809–819. [PubMed] [Google Scholar]
- Miller H. C., Gibson D. G., Stephens J. D. Role of echocardiography and phonocardiography in diagnosis of mitral paraprosthetic regurgitation with Starr-Edwards prostheses. Br Heart J. 1973 Dec;35(12):1217–1225. doi: 10.1136/hrt.35.12.1217. [DOI] [PMC free article] [PubMed] [Google Scholar]
- St John Sutton M. G., Tajik A. J., Mercier L. A., Seward J. B., Giuliani E. R., Ritman E. L. Assessment of left ventricular function in secundum atrial septal defect by computer analysis of the M-mode echocardiogram. Circulation. 1979 Nov;60(5):1082–1090. doi: 10.1161/01.cir.60.5.1082. [DOI] [PubMed] [Google Scholar]
- St John Sutton M. G., Traill T. A., Ghafour A. S., Brown D. J., Gibson D. G. Echocardiographic assessment of left ventricular filling after mitral valve surgery. Br Heart J. 1977 Dec;39(12):1283–1291. doi: 10.1136/hrt.39.12.1283. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sutton M. G., Miller G. A., Oldershaw P. J., Paneth M. Anticoagulants and the Björk-Shiley prosthesis. Experience of 390 patients. Br Heart J. 1978 May;40(5):558–562. doi: 10.1136/hrt.40.5.558. [DOI] [PMC free article] [PubMed] [Google Scholar]
