Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
2
pubmed:dateCreated
1994-9-8
pubmed:abstractText
Over a period of 10 years, 25 patients underwent reoperation for prosthetic valve endocarditis. The basic procedure for surgical treatment differed depending on the presence or absence of annular ring abscess. Standard valve replacement was employed in 15 patients without annular ring abscess (three aortic, eleven mitral and one tricuspid). The ten other patients who had had partial destruction of the annulus underwent complex surgical treatment (six aortic, three mitral and one aortic and mitral). Complex operative techniques consisted of three different procedures, depending on the anatomical lesion in each patient. Aortic valve replacement was performed by subannular implantation with horizontal Dacron felt-supported mattress sutures through the ventricular septum, ventricular outflow wall muscles and base of the anterior mitral leaflet. A prosthesis with a polytetrafluoroethylene flange was used for mitral valve replacement to permit double suturing of the prosthesis and firm anchoring. Double valve replacement (mitral, aortic) with destruction of the fibrous skeleton was carried out using a composite graft consisting of a triangular-shaped Dacron patch and two Björk-Shiley valves. There were four operative deaths (16%; three who underwent standard valve replacement and one who had complex surgical treatment). In no case could the cause of death be related to the surgical procedure. These patients had had haemodynamic decompensation before operation and required urgent reoperation. Preoperative New York Heart Association functional class IV (P < 0.05) and operative urgency (P < 0.05) had a significant correlation with mortality. On the basis of these results, operative mortality can be improved if conditions leading to myocardial damage are prevented and proper reconstruction conducted.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Apr
pubmed:issn
0967-2109
pubmed:author
pubmed:issnType
Print
pubmed:volume
2
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
212-5
pubmed:dateRevised
2004-11-17
pubmed:meshHeading
pubmed-meshheading:8049948-Adult, pubmed-meshheading:8049948-Aged, pubmed-meshheading:8049948-Aortic Valve, pubmed-meshheading:8049948-Emergencies, pubmed-meshheading:8049948-Endocarditis, pubmed-meshheading:8049948-Female, pubmed-meshheading:8049948-Follow-Up Studies, pubmed-meshheading:8049948-Heart Valve Prosthesis, pubmed-meshheading:8049948-Humans, pubmed-meshheading:8049948-Incidence, pubmed-meshheading:8049948-Male, pubmed-meshheading:8049948-Middle Aged, pubmed-meshheading:8049948-Mitral Valve, pubmed-meshheading:8049948-Polyethylene Terephthalates, pubmed-meshheading:8049948-Polytetrafluoroethylene, pubmed-meshheading:8049948-Postoperative Complications, pubmed-meshheading:8049948-Prosthesis Design, pubmed-meshheading:8049948-Reoperation, pubmed-meshheading:8049948-Surgical Procedures, Elective, pubmed-meshheading:8049948-Survival Rate, pubmed-meshheading:8049948-Suture Techniques, pubmed-meshheading:8049948-Treatment Outcome
pubmed:year
1994
pubmed:articleTitle
Prosthetic valve endocarditis: surgical procedures and clinical outcome.
pubmed:affiliation
Department of Surgery, Osaka National Hospital, Japan.
pubmed:publicationType
Journal Article