PMID- 7626869
OWN - NLM
STAT- MEDLINE
DCOM- 19950905
LR  - 20190920
IS  - 0886-0440 (Print)
IS  - 0886-0440 (Linking)
VI  - 10
IP  - 3
DP  - 1995 May
TI  - The CarboMedics "top hat" supraannular prosthesis in the small aortic root.
PG  - 198-204
AB  - Twenty-three patients, 11 men and 12 women, with a mean age of 64 (range, 34 to 
      78) underwent aortic valve replacement (AVR) with a CarboMedics "Top Hat" 
      supraannular prosthesis between March 1993 and August 1994. The top hat 
      supraannular prosthesis, a standard bileaflet valve with the cuff transferred to 
      the valve inflow level, allowed implantation of 21-mm, 23-mm, and 25-mm valves, 
      where a standard 19-mm or 21-mm valve would have usually been placed. One patient 
      who had been in preoperative cardiogenic shock died in the perioperative period. 
      Another had an intraoperative cerebral embolism with permanent impairment. 
      Follow-up on 22 of 23 patients over a mean period of 9 months revealed mean 
      Doppler gradients of 18 +/- 6 mmHg, 15 +/- 2.8 mmHg, and 11 mmHg, for the 21-mm, 
      23-mm, and 25-mm valves, respectively. Functional improvement was noted, with 17 
      patients in New York Heart Association (NYHA) Class I and 6 in NYHA Class II, 
      postoperatively, compared with 0 in Class I, 9 in Class II, 10 in Class III, and 
      4 in Class IV, preoperatively. One patient showed reduced postoperative 
      ventricular function with fractional shortening below 25%. Pandiastolic 
      regurgitation intrinsic to the valve graded as slight was noted in all patients. 
      Other postoperative complications included one patient with anticoagulant-related 
      gastrointestinal bleeding and one other with prosthetic valve endocarditis 
      successfully treated with antibiotics. The CarboMedics top hat valve allows a 
      gain in prosthesis size of 2 mm to 4 mm in the aortic position over standard 
      prostheses, resulting in favorable postoperative hemodynamics.
FAU - Roedler, S
AU  - Roedler S
AD  - Department of Cardiology, University of Vienna, Wahringergurtel Vienna, Austria.
FAU - Moritz, A
AU  - Moritz A
FAU - Wutte, M
AU  - Wutte M
FAU - Hoda, R
AU  - Hoda R
FAU - Wolner, E
AU  - Wolner E
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - United States
TA  - J Card Surg
JT  - Journal of cardiac surgery
JID - 8908809
SB  - IM
MH  - Adult
MH  - Aged
MH  - *Aortic Valve
MH  - Echocardiography, Doppler
MH  - Female
MH  - Follow-Up Studies
MH  - *Heart Valve Prosthesis/mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prosthesis Design
EDAT- 1995/05/01 00:00
MHDA- 1995/05/01 00:01
CRDT- 1995/05/01 00:00
PHST- 1995/05/01 00:00 [pubmed]
PHST- 1995/05/01 00:01 [medline]
PHST- 1995/05/01 00:00 [entrez]
AID - 10.1111/j.1540-8191.1995.tb00599.x [doi]
PST - ppublish
SO  - J Card Surg. 1995 May;10(3):198-204. doi: 10.1111/j.1540-8191.1995.tb00599.x.