| Early failure of an autologous pericardium aortic heart valve (ATCV) prosthesis. | |
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MedLine Citation:
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PMID: 9502136 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND AIMS OF THE STUDY: The risk of reoperation due to calcific degeneration is the most important drawback of biological heart valves compared with mechanical prostheses. Concepts to mitigate calcification have been tested experimentally and clinically, but none has proven completely to prevent degeneration. METHODS: Renewed interest has involved the use of autologous pericardium for intraoperative construction of autologous aortic valves (ATCV). RESULTS: Of 10 ATCV implanted between 1994 and 1996, one was removed from an 84-year-old female 27 months after implantation because of severe valvular insufficiency. Eight months earlier, a broken spring of the stent system was detected radiographically, with normal valvular competence at echocardiography. Valve dysfunction was due to shrinkage of one leaflet. Measurement of tissue calcium by atomic absorption spectroscopy showed high levels in the shrunken leaflet compared with two intact leaflets (42.82 versus 0.51 and 2.42 mg Ca2+/g). Histology and immunohistology demonstrated extensive fiber degeneration without inflammation or immune reactions in the destroyed leaflet, and moderate fiber degeneration in intact leaflets. Scanning electron microscopy showed smooth surfaces in the normal leaflet and exposure of collagen in the degenerated leaflet in association with calcium deposition. CONCLUSIONS: In contrast to the outcome in animal studies, intraoperative tanning did not prevent tissue shrinkage in this case. Leaflet malfunction was associated with calcification. At present, the clinical use of valves constructed from autologous pericardium can not be recommended. |
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Authors:
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M Dahm; D Prüfer; E Mayer; E Groh; Y H Choi; H Oelert |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of heart valve disease Volume: 7 ISSN: 0966-8519 ISO Abbreviation: J. Heart Valve Dis. Publication Date: 1998 Jan |
Date Detail:
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Created Date: 1998-04-23 Completed Date: 1998-04-23 Revised Date: 2006-05-04 |
Medline Journal Info:
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Nlm Unique ID: 9312096 Medline TA: J Heart Valve Dis Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 30-3 Citation Subset: IM |
Affiliation:
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Department of Cardiothoracic and Vascular Surgery, University Hospital Mainz, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Aortic Valve Bioprosthesis* Calcinosis / etiology Female Heart Valve Prosthesis* Heart Valve Prosthesis Implantation Humans Prosthesis Failure Stents Time Factors Transplantation, Autologous |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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