PMID- 10609904
OWN - NLM
STAT- MEDLINE
DCOM- 20000128
LR  - 20190513
IS  - 1010-7940 (Print)
IS  - 1010-7940 (Linking)
VI  - 16
IP  - 5
DP  - 1999 Nov
TI  - Midterm results after aortic valve replacement with the autologous tissue cardiac 
      valve.
PG  - 533-9
AB  - OBJECTIVE: To assess midterm results after aortic valve replacement (AVR) with an 
      autologous tissue cardiac valve (ATCV). This new technique was developed to 
      construct a tissue prosthesis for AVR using the patients pericardium, harvested 
      at the time of operation with negligible effect on operating time. METHODS: 
      Briefly, glutaraldehyde tanned pericardium is mounted on a stent requiring no 
      suturing. Between March 1994 and December 1996, 87 patients, 44/43 M/F and aged 
      70 +/- 6 years had AVR for aortic stenosis (80%), aortic insufficiency (6%) and 
      combined lesions (14%), one patient suffered from endocarditis. Additional 
      coronary artery bypass was done in 25%, aortic root enlargement in 7%. Aortic 
      cross clamp and cardiopulmonary bypass times were 69 +/- 21 and 93 +/- 29 min. 
      All patients were followed by clinical examination and color flow Doppler 
      echocardiography in 3-12 months interval. Follow up was 99% complete. RESULTS: 
      There were five perioperative deaths (6%), none of them valve related. Eighty-one 
      patients were followed up to a period of 52 months (mean interval 37.5 +/- 1.3 
      months), one patient was lost for follow up. Overall survival was 86, 81, 79 and 
      71% at 12, 24, 36 and 48 months, respectively. There were 14 late deaths with 
      eight (10%) valve related (four cerebral deaths, four sudden deaths). Sixteen 
      patients (20%) had to be re-operated due to severe valve incompetence. Freedom 
      from reoperation was 98, 97, 90 and 63% at 12, 24, 36, and 48 months, 
      respectively. Valve incompetence occurred suddenly, without previous signs in the 
      follow-up examinations. Selection and preparation of the pericardium, the way of 
      fixation of the tissue--brief immersion in glutaraldehyde--and engineering 
      problems might be responsible for this disastrous outcome. CONCLUSION: Due to 
      these results we must state, that the ATCV did not fulfill our expectations and 
      presently we can not recommend it as an aortic valve substitute.
FAU - Gross, C
AU  - Gross C
AD  - General Hospital Linz, Austria.
FAU - Simon, P
AU  - Simon P
FAU - Grabenwoger, M
AU  - Grabenwoger M
FAU - Mair, R
AU  - Mair R
FAU - Sihorsch, K
AU  - Sihorsch K
FAU - Kypta, A
AU  - Kypta A
FAU - Grimm, M
AU  - Grimm M
FAU - Brucke, P
AU  - Brucke P
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Valve Insufficiency/mortality/*surgery
MH  - *Bioprosthesis
MH  - Female
MH  - Follow-Up Studies
MH  - Graft Rejection
MH  - Graft Survival
MH  - Heart Valve Prosthesis Implantation/*adverse effects/methods/mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prosthesis Design
MH  - Survival Analysis
MH  - Time Factors
MH  - Transplantation, Autologous
MH  - Treatment Outcome
EDAT- 1999/12/28 00:00
MHDA- 1999/12/28 00:01
CRDT- 1999/12/28 00:00
PHST- 1999/12/28 00:00 [pubmed]
PHST- 1999/12/28 00:01 [medline]
PHST- 1999/12/28 00:00 [entrez]
AID - S1010-7940(99)00309-7 [pii]
AID - 10.1016/s1010-7940(99)00309-7 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 1999 Nov;16(5):533-9. doi: 
      10.1016/s1010-7940(99)00309-7.