Mid-terme results of cardiac surgery of valve replacement by mechanical prosthesis. About 861 patients

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Published Sep 18, 2017
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Vol. 94 No. 11 (2016): Issue Nov 2016

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DJAFER Boulanouar

Abstract

Background: Patients with mechanical valvular prostheses are becoming more numerous in our country. Their medical care poses a number of problems in a particular socio-economic context of our geographical regions.

Aim : The purpose of this study was to identify the complications of this heart valve replacement surgery by mechanical prostheses and try to compare our results with those of literature.

Methods : From January 1998 to June 2003, 861 patients were operated for acquired valvular heart disease (413 men and 448 women), average age 39±11 years. It was 495 mitral valve replacement, 205 aortic valve replacement, 158 mitral-aortic replacement  and 3 aorto-mitral-tricuspid replacement. One hundred seventy eight (178) gestures were needed on the tricuspid valve.

Results : Hospital mortality was 6.2% CI [5.0 - 8.5]. Remote 9 years mortality was 21 deaths. No structural deterioration prosthesis occurred. Hospital Morbidity was 14  thromboembolism, 52 hemorrhage  and 8 mediastinitis. Remote morbidity was 3 strokes, 2 serious gastrointestinal bleeding and two endocarditis. The survival rate at 5 years was 90 % CI [0.88 - 0.91].

Conclusion : Heart valve replacement surgery with mechanical prostheses gives satisfactory results in the medium term.

Keywords:

Replacement valvular cardiac surgery, cardiac valvular prostheses, cardiopulmonary bypass, valve-gated accidents

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References

  1. Chauvaud S, Fuzellier JF, Berrebi A et al. Long-term (29 years) results of reconstructive surgery in rheumatic mitral valve insufficiency. Circulation 2001 ; 104 (Suppl. 1) : I-12-I-15.
  2. Tribouilloy C et al. Recommandations de la société française de cardiologie concernant la prise en charge des valvulopathies acquises et dysfonctions de prothèse valvulaire. Indications opératoires et interventionnelles. Arch Mal CÅ“ur Vaiss, tome 98, n°2(suppl), février 2005.
  3. Hermann HC, Spann JF. Indications for heart valve replacement. Clin Cardiol 1990 feb 13(2) :81-8.
  4. Durand M, Anglade D, Giradet P. Evaluation préopératoire des facteurs de risque. In ; JANVIER G, LEHOT JJ. Circulation extracorporelle : Principes et pratique. Groupe Liaisons. SA. 2002: 9-16.
  5. Edmunds LH, Clark RE, Cohn LH, Miller DC, Weisel RD. Guidelines for reporting morbidity and mortality after cardiac valvular operations. J Thorac Cardiovasc Surg, 1988; 96:351-353.
  6. Edmunds LH Jr, Clark RE, Cohn LH, Grunkemeier GL, Weisel RD. Guidelines for reporting morbidity andmortality after cardiac valvular operations. Ad Hoc Liaison Committee for standardizing Definitions of Prosthetic Heart Valve Morbidity of The American Association of Thoracic Surgery and The Society of Thoracic Surgeons. J Thorac Cardivasc Surg 1996 Sep; 112 (3):708-11.
  7. Edmunds LH Jr, Clark RE, Cohn LH, Grunkemeier GL, Weisel RD. Guidelines for reporting morbidity and mortality after cardiac valvular operations. The American Association for Thoracic Surgery, Ad Hoc Liaison Committee for Standardizing Definitions of Prosthetic Heart Valve morbidity. Annal Thorac Surg 1996 Sep; 62(3):932-5.
  8. Brown PS, Roberts CS, Mcintosh CL et al. Late results after triple valve replacement with various substitute valves. Ann Thorac Surg, 1993, 55:502-508.
  9. Galloway AC, Grossi EA, Baumann FG et al. Multiple valve operation for advanced heart disease: results and risk factors in 513 patients. J Am Coll Cardiol, 1992, 19: 725-732.
  10. Bensaid J. Résultats de la chirurgie de remplacement valvulaire par prothèses. In: ACAR J, ACAR C. Cardiopathies valvulaires acquises. Paris. Flammarion Médecine-Sciences, 2000: 529-554.
  11. Fabiani JN, Deloche A, D'Allaines C, Dubost C. Résultats de la chirurgie des valvulopathies (à propos de 939 cas opérés). Journées Internationales de Cardioogie, Deauville, octobre 1974. Coeur, numéro spécial, 1975, 649-65712.
  12. Logen F. Résultats à long terme des remplacements valvulaires mitraux chez les malades porteurs de lésion mitrale et mitro-tricuspidienne. Coeur vol. XI, n°2, mars-avril1980:224-30 Maloine S.A.
  13. Pornin M, Rocher R, Pipeau C et al. Evolution à long terme des remplacements valvulaires mitraux. Coeur vol.XI, n°2, mars-avril 1990:214-22 Maloines S.A.
  14. Remadi JP, Baron O, Bisouarn P et al. Isolated mitral valve replacement with st-jude medical prosthesis: long term results: a follow up for 19 years. Circulation 2001 Mar; 103(11):15426.
  15. Akins CW. Mechanical cardiac valvular prostheses. Ann Thorac Surg. 1991, 52:16-172.
  16. Akins CW. Results with mechanical cardiac valvular prosthesis. Ann Thorac Surg. 1995, 60: 1836-1844
  17. Nashef SAM, Stewart NI, Bain WH. Heart valve replacement: thromboembolism or thrombosis and embolism? In; BODNAR E. Surgery for heart valve disease, London, ICR Publishers, 1990: 159-170
  18. Ansari MT, Ahmedzai N, Coyle K, Coyle D, Moher D. Mitral valve clip for treatment of mitral regurgitation: An evidence based analysis. Ont Health Assess Ser.2015;15(12):1-104.
  19. Antunes MJ. Challenges in rheumatic valvular disease: Surgical strategies for mitral valve preservation. Glob Cardiol Sci Pract. 2015; 2015:9.
  20. Shmuel Banai, Stefan Verheye, Anson Cheung et al. Tran Apical Mitral Implantation (TAMI) oft he Tiara â„¢ Bio-prosthesis:Preclinical results. JACC Cardiovasc Interv. 2014 Feb; 7(2): 154-162.
  21. Caroline A. Kim, Suraj P. Rasania, Jonathan Afilalo et al. Functional status and quality of life after transcayheter aortic valve replacement: A systematic review. Ann Intern Med.2014 Feb 18; 160(4):243-254.
  22. Oliemy A, Al-Attar N. Transcatheter aortic valve implantation. F1000Prime Rep. 2014; 6: 92.
  23. Ming LI, Dumitru Mazilu, Keith A. Horvath. Minimally invasive cardiac surgery: Transapical aortic valve replacement. Minim Invasive Surg. 2012: 145381.
  24. Cary. W. Akins, D. Craig Miller, Marko I. Turina et al. Guidelines for reporting mortality and morbidity after cardiac valve interventions. J Thorac Cardiovasc Surg 2008; 135: 732 - 738.
  25. Kingue S, Ba S, Balde D et al. The valvafric atudy: A registry of rheumatic heart disease in western and central Africa. Arch Cardiovasc Dis. 2016 May; 109(5): 321 - 9.
  26. Russel EA, Tran L, Baker RA et al. A review of outcome following valve surgery for rheumatic heart disease in Australia. BMC Cardiovasc Disord. 2015 Sep 23; 15: 103.
  27. Liu W, He F, Shi G. Success rates and prognosis of heart valvuloplasty and valve replacement performed for elderly patients. Pack J Med Sci. 2015 Sep-Oct; 31(5):1033-7.
  28. Naslafkih A, Francois S, Fix JM, Khoury A. Aortic valve replacement and long-term prognosis. J Insur Med. 2006;38(2):126-35.
  29. Demirag MK, Kelecigil HAT, Kolbakir F. Late term results of mitral valve replacement with st. Jude Medical mechanical valve prosthesis: Samsun experience. Acta Cardiol. 2006 Oct; 61(5):537-44.