Document Detail


Hemolysis, high-intensity transient signals (HITS) and hemodynamic results after aortic valve replacement with the Medtronic Hall Easy-Fit heart valve prosthesis.
MedLine Citation:
PMID:  16607897     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIM OF THE STUDY: Previous studies have shown a correlation between type, orientation and valve size of mechanical heart valve prostheses and the incidence of high-intensity transient signals (HITS). The study aim was to investigate the presence of HITS and hemolysis and the impact of valve size and hemodynamic parameters following aortic valve replacement (AVR) using the new Medtronic Hall Easy-Fit prosthesis. METHODS: A total of 150 patients (120 males, 30 females; mean age 62 +/- 8 years; range: 32-78 years) underwent AVR (n = 94; 63% concomitant procedures) with the Easy-Fit valve in its optimal orientation. Patients were investigated at between three and 36 months after AVR using transcranial Doppler examination of the right and left middle cerebral artery, and the incidence of HITS was determined. For evaluation of hemolysis, serum lactate dehydrogenase (LDH), hemoglobin and bilirubin were measured. These parameters were related to valve size. Transthoracic echocardiography was performed in all patients. RESULTS: Among the patients, 112 (75%) showed no or low HITS (34% none, 41% < 30/h), while only 38 (25%) had elevated HITS (range 31-100/h, 14%; range > 100/h, 11%). Statistical analysis showed a linear association between the HITS count and valve size. A positive correlation between valve size and LDH was observed; hemoglobin and bilirubin showed normal values. CONCLUSION: The valve size-dependent increase in LDH after AVR corresponds with the observation that the presence of HITS increases with valve size. In light of these findings, the surgical approach to implant the largest size Easy-Fit valve possible should be discussed, given the excellent hemodynamic results provided by the valve, even in smaller sizes.
Authors:
Roland H Warnecke; Joachim Laas; Hartmut Hecker; Matthias Perthel; Aiman Alken
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of heart valve disease     Volume:  15     ISSN:  0966-8519     ISO Abbreviation:  J. Heart Valve Dis.     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-04-12     Completed Date:  2006-07-25     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9312096     Medline TA:  J Heart Valve Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  174-9     Citation Subset:  IM    
Affiliation:
Department of Cardiothoracic Surgery, Cardiovascular Center Bad Bevensen, Bad Bevensen, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aortic Valve*
Female
Heart Valve Diseases / surgery*,  ultrasonography
Heart Valve Prosthesis*
Heart Valve Prosthesis Implantation / adverse effects*,  instrumentation
Hemolysis*
Humans
Incidence
Male
Middle Aged
Postoperative Complications
Prosthesis Design
Stroke / epidemiology,  etiology*,  ultrasonography
Ultrasonography, Doppler, Transcranial*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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