• Journal of Chest Surgery
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• v.25 no.7
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• pp.750-755
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• 1992

We report a case of leaflet embolization of central leaflet fracture a 31mm mitral Edw-ards-Duromedics prosthesis. A leaflet was fractured to two segments, a larger one embolized to right common iliac artery and a smaller one to left femoral artery, respectively. Patient was reoperated with 29mm mitral Carbomedics prosthesis and incidentally found of smaller segment in left femoral artery at cannulation site. The embolectomy was done 15 days after cardiac operation through midline abdominal incision, Leaflet escape of a mitral Edward-Duromedics prosthesis is a rare, potentially curable mode of valve failure. After mechanical valve replacement, unexplained heart failure and acute pulmonary edema, mechanical valve failure should be suspected. Correct interpretation of clinical signs, symptoms and fluroscopy should allow early diagnosis of leaflet escape and prompt surgical therapy.

• Journal of Chest Surgery
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• v.46 no.5
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• pp.380-382
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• 2013

• Journal of Biomedical Engineering Research
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• v.12 no.3
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• pp.149-156
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• 1991

In this paper, fluttering behavior of mechanical bileaflet heart valve prosthesis was analyzed taking into consideration of the impact between valve plate and stopper Vibration system of the valve was modeled as a rotating system, and equations are induced by moment equilibrium equations. Lift force, drag force, gravity and buoyancy were considered as external forces acting on the valve plate/ The 4th order Runge-Kutta method was used to solve the equations. Valve plate does not come to the static equilibrium position at a stretch, but come to that position after under damping vibration. Damping ratio increases as the cardiac optput increases, and the mean damping ratio is in the range of 0.16~40.25. Fluttering frequency does not have any specific value, but varies as a function of time. It is in the range of 10~40Hz. Valve opening appears to be affected by the orientation of the of the valve relative to gravitational forces.

• Journal of Chest Surgery
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• v.22 no.4
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• pp.693-697
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• 1989

A forty-eight-year-old female patient with ascending aortic aneurysm with aortic insufficiency underwent a modified Bentall operation. The ascending aorta and the aortic valve were replaced with a composite graft containing a St. Jude valve. The coronary orifices were anastomosed to the tubular Dacron prosthesis by means of a second smaller Gore-Tex tube, and a fistula between the aneurysmal sac and the right atrial appendage was created to drain oozing from the prosthesis. The postoperative course was uneventful and the patient was discharged without complication. She is doing well on the 14 months follow-up.

• Journal of Chest Surgery
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• v.21 no.4
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• pp.706-710
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• 1988

Intravascular hemolysis occurs in the majority of patient with mechanical valve prosthesis. The primary cause is mechanical trauma to red cells from turbulent blood flow through the prosthesis. Degree of hemolysis is dependent upon the type, size and material of valve and aggravated by paravalvular leakage. Clinically important hemolytic anemia is required medical management or consideration of reoperation. In severe hemolysis, reoperation is recommended without delay when seems to be renal failure. In this case, postoperative severe mechanical hemolysis was developed immediately after aortic valve replacement with St. Jude medical valve in a 13 year-old male patient. Neither significant paravalvular leakage nor valvular dysfunction was found through redo, but the mechanical valve was strongly suspected the cause of severe hemolysis. The St. Jude Medical valve was changed with Ionescu-Shiley bioprosthesis and any significant clinical problems were not noted through the postoperative course.

• Journal of Chest Surgery
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• v.50 no.6
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• pp.467-470
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• 2017

Extensive mitral annulus calcifications are considered a contraindication for valve surgery. We describe the case of a 76-year-old female with severe mitral and aortic stenosis associated with extensive calcifications of the heart. The patient underwent an open mitroaortic valve replacement using transcatheter aortic valve implantation with an Edwards SAPIEN XT valve (Edwards Lifesciences Corp., Irvine, CA, USA) in the mitral position. The aortic valve was replaced using a stentless valve prosthesis (LivaNova S OLO; LivaNova PLC, London, UK). Postoperative echocardiography showed that the prosthetic valve was in the correct position and there were no paravalvular leaks. A bailout open transcatheter valve implantation can be considered a safe and effective option in selected cases with an extensively calcified mitral valve.

• Journal of Chest Surgery
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• v.35 no.1
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• pp.60-63
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• 2002

Edwards Duromedics mechanical valve was introduced into clinical use in 1982 and is still being used today after several modifications. Valve-related complications after mechanical valve replacement are thiombo-embolism, endocarditis, valve malfunction, valve leaflet escape and fracture. Incidence of valve leaflet escape is very low. A 40 year-old male patient who had undergone mitral replacement with a 31mm Edwards Duromedics mechanical valve(model

• Journal of Chest Surgery
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• v.37 no.4
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• pp.373-375
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• 2004

Edwards Duromedics Valve has been suspended from the market since May 1988 due to the frequent reports of leaflet escape. There were 2 case-reports of leaflet escapes in this country. We report a case of leaflet escape in an Edwards Duromedics bileaflet valve, in the mitral position.

• Journal of Biomedical Engineering Research
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• v.19 no.3
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• pp.291-296
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• 1998

A new mechanical heart valve prosthesis has been designed appling systematic design methodology. The function of the heart valve was defined, and search for design variation has been carried out according to the functional structure, Optimal model among the various variations was determined in view of the design specificationn. Proto type valve was fabricated and test has been carried out using a mock circulation system. It has been observed that the pressure profile, cardiac output and behavior characteristics are generally satisfactory.

• Journal of Chest Surgery
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• v.51 no.2
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• pp.100-108
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• 2018

Background: The question of which type of prosthetic aortic valve leads to the best outcomes in patients in their 60s remains controversial. We examined the hemodynamic and clinical outcomes of aortic valve replacement in sexagenarians according to the type of prosthesis. Methods: We retrospectively reviewed 270 patients in their 60s who underwent first-time aortic valve replacement from 1995 to 2011. Early and late mortality, major adverse valve-related events, anticoagulation-related events, and hemodynamic outcomes were assessed. The mean follow-up duration was $58.7{\pm}44.0$ months. Results: Of the 270 patients, 93 had a mechanical prosthesis (mechanical group), and 177 had a bioprosthesis (tissue group). The tissue group had a higher mean age and prevalence of preoperative stroke than the mechanical group. The groups had no differences in the aortic valve mean pressure gradient (AVMPG) or the left ventricular mass index (LVMI) at 5 years after surgery. In a sub-analysis limited to prostheses in the supra-annular position, the AVMPG was higher in the tissue group, but the LVMI was still not significantly different. There was no early mortality. The 10-year survival rate was 83% in the mechanical group and 90% in the tissue group. The type of aortic prosthesis did not influence overall mortality, cardiac mortality, or major adverse valve-related events. Anticoagulation-related events were more common in the mechanical group than in the tissue group (p=0.034; hazard ratio, 4.100; 95% confidence interval, 1.111-15.132). Conclusion: The type of aortic prosthesis was not associated with hemodynamic or clinical outcomes, except for anticoagulation-related events.