A Clinical Study of Isolated Aortic Valve Replacement with CarboMedics and St. Jude Prosthesis

카보메딕스 대동맥판막과 쎈트쥬드 대동맥판막의 임상성적

  • Kim, Wook-Sung (Department of Thoracic & cardiovascular Surgery, Sejong General Hospital) ;
  • Kim, Ki-Bong (Department of Thoracic & cardiovascular Surgery, Seoul National University College of Medicine) ;
  • Anh, Hyuk (Department of Thoracic & cardiovascular Surgery, Seoul National University College of Medicine) ;
  • Chae, Hurn (Department of Thoracic & cardiovascular Surgery, Samsung Medical Center) ;
  • Kim, Chong-Whan (Department of Thoracic & cardiovascular Surgery, Sejong General Hospital)
  • 김욱성 (부천세종병원 흉부외과) ;
  • 김기봉 (서울대학교 의과대학 흉부외과학 교실) ;
  • 안혁 (서울대학교 의과대학 흉부외과학 교실) ;
  • 채헌 (삼성의료원 흉부외과) ;
  • 김종환 (부천세종병원 흉부외과)
  • Published : 1998.08.01

Abstract

Materials and methods: Between 1984 to 1994, 136 patients underwent primary and isolated aortic valve replacement with 79 Carbomedics and 57 St. Jude prostheses. Results: Age ranged from 16 to 67 year(mean : 44.5${\pm}$12.7 years). Statistically significant differences in preoperative clinical characteristics between two groups were not found. There was one early death in the St. Jude group and none in the Carbomedics group. Early prosthetic valve-related complications including death were not significantly different between the two groups(p value= 0.572). One hundred thirty five early survivors were followed for a total of 354.2 patient-years(mean=31.5${\pm}$16 months). In the CarboMedics group, actuarial survial rate at 5 years was 97.1${\pm}$1.9%, and in the St. Jude group, it was 95.9${\pm}$2.8%. In the CarboMedics group, actuarial free rate from all valve-related events at 5 years was 92.1${\pm}$3.1%, and in St. Jude group, it was 89.8${\pm}$5.0%. Conclusion: We conclude that early and late results after performing isolated aortic valve replacement with CarboMedics and St. Jude valve are not significantlly different.

대상 및 방법: 1984년부터 1994년까지 서울대학병원 흉부외과에서 79례의 카보메딕스판막과 57례의 쎈트쥬드판막을 사용한 단일 대동맥판막 치환술을 시행하였다. 결과: 연령분포는 16세에서 67세까지로 평균연령은 44.5$\pm$12.7세였다. 수술전 카보메딕스판막 환자군과 쎈트쥬드판막 환자군에서의 임상적 특성은 통계적으로 유의한 차이가 없었다. 조기사망은 쎈트쥬드판막 환자군 에서 1례(1.7%)가 발생하였고, 카보메딕스판막 환자군에서는 조기사망환자가 없었다. 조기사망을 포함한 판막 관련 조기합병증은 두 군에서 통계적으로 유의한 차이가 없었다(p value=0.572). 평균 추적기간은 31.5$\pm$16.1 개월이었으며, 5년 생존률은 카보메딕스환자군에서 97.1$\pm$1.9%이고, 쎈트쥬드판막환자군에서 95.9$\pm$2.8%였다 (p=0.7847). 판막관련 사망이나 합병증 없는 5년 생존률은 카보메딕스판막 환자군에서 92.1$\pm$3.1%이고, 쎈트쥬드판막 환자군 에서 89.8$\pm$5.0%였다(p value=0.8732). 결론: 결론적으로 카보메딕스판막과 쎈트쥬드판막을 사용하여 단일 대동맥치환술을 시행하였을 때, 조기 성적 및 만기성적은 통계적으로 유의한 차이가 없었다.

Keywords

References

  1. Jpn J Artif Oragans v.18 CarboMedics cardiac valve prosthesis Kawai A;Fujino S;Wantanabe S;Hashimoto E;Koyanagi A
  2. J Thorac Cardiovasc Surg v.96 Guidlines for reporting morbidity and mortality after cardiac valvular operations Edmunds LH;Clark RE;Cohn LH;Miller C;Weisel RD
  3. Asian cardiovasc Thoracic Ann v.3 A clinical study of isolated aortic valve replacement : a univariate analysis of risk factors Kim Wook Sung;Lee Jeong Ryul;Kim Ki Bong(et al)
  4. Ann Thorac Surg v.56 st. Jude prosthesis for aortic and mitral valve replace- ment: A ten-year experience Kratz JM;Crawford FA;Sade RM;Crumbley AJ;Stroud MR
  5. Ann Thorac Surg v.44 Thrombotic and bleeding complications of prosthetic heart valves Edmunds LH
  6. Ann Thorac Surg v.47 Ten years' experience with the st. Jude Medical valve prosthesis Arom KV;Nicoloff DM;kersten TE;Northrup WF;Lindsay WG;Emery RW
  7. J Thorac Cardiovasc Surg v.107 Early and late-phase events after valve replacement with the St. Jude Medical prosthesis in 1200 patients Fernandez J;Laub GW;Adkins MS(et al)
  8. J. Thorac Cardiovasc Surg v.100 Ten-year experience with the St. Jude Medical valve for primary valve replacement Czer LC;Chaux A;Matloff JM(et al)
  9. J Thorac Cardiovasc Surg v.106 Mid-term follow-up after heart valve replacement with Carbomedics bileaflet prostheses Luca L;Nicola V;Giannolo B;Cafarella G;Piazza L;Cotrufo M
  10. Ann Thorac Surg v.58 Four-year experience with the CarboMedics valve: The north american experience Copeland JG;Sethi GK
  11. J Cardiovasc Surg v.34 The carboMedics prosthetic heart valve Aupart MR;Hammami SE;Diemont F;Sirinelli AL;BahA;Marchand MA
  12. Surg Today Jpn J Surg v.25 Mid-term surgical results after valve replacement with the CarboMedics valve prosthesis Abe T;Morishta K;Tsukamoto M;Tanaka T;Komatsu S
  13. N Engl J Med v.333 Optimal oral anticoagulant therapy in patients with mechanical heart valves Cannegieter SC;Rosendaal FR;Wintzen AR;Meer FJM;Vandenbroucke JP;Briet E
  14. J Thorac Cardiovasc Surg v.107 Lower intensity anticoagulation therapy results in lower complication rates with the St. Jude Medical prosthesis Horstkotte D;Schulte HD;Bircks W;Strauer BE
  15. Thorac Cardiovasc Surgeon v.41 Low-dose anticoagulant management of patients with St. Jude Medical mechanical valve prostheses Yamk B;Karagoz HY;Zorlutuna Y;Eralp A;Tasdemir O;Bayazit K
  16. Artif Organs v.20 Clinical use of carboMedics and St. Jude Medical valves Wang SS;Chu SH;Tasi CH;Lin FY
  17. 대흉외지 v.28 쎈트쥬드 대동맥판막의 장기임상성적 김종환