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Mid-term results of ATS open pivot bileaflet mechanical prosthetic heart valve
1Second Department of Surgery, Nihon University School of Medicine, 30-1 Oyaguchi-kamimachi, Itabashi-ku, Tokyo 173-8610, USA.
Insights
The ATS bileaflet valve demonstrates excellent mid-term results, showing safe performance and improved patient quality of life. Most patients found the valve sound unnoticeable, indicating good clinical outcomes.
Area of Science:
- Cardiovascular Surgery
- Biomedical Engineering
- Prosthetic Heart Valves
Background:
- Mechanical heart valves are crucial for treating valvular heart disease.
- Bileaflet mechanical valves are widely used, but their long-term performance and patient impact require ongoing evaluation.
Purpose of the Study:
- To evaluate the mid-term clinical outcomes and patient-reported experiences with the ATS bileaflet valve.
- To assess the safety and efficacy of the ATS valve through various clinical and audiological parameters.
Main Methods:
- Retrospective analysis of 69 patients who received ATS bileaflet valve replacement over 6 years.
- Monitoring of serum lactate dehydrogenase (LDH) levels and patient questionnaires regarding valve sound perception.
- Frequency analysis of valve closing sounds and review of postoperative complications, mortality, and survival rates.
Main Results:
- Serum LDH levels normalized within one week postoperatively and remained stable.
- 88.4% of patients did not notice the valve sound; among those who did, most were reoperation cases.
- The ATS valve closing sound peaked around 1.2 kHz, distinct from St. Jude Medical valves.
- Thromboembolic event-free rate was 98.6%, and actuarial survival was 94.2% over 1-66 months follow-up.
- One case of postoperative cerebral infarction and 5.7% mortality were recorded.
Conclusions:
- The ATS bileaflet valve is a safe option for valve replacement, offering excellent mid-term results.
- The valve contributes positively to patients' quality of life, with minimal audibility and low complication rates.
Abstract:
We investigated mid-term results of the patients with an ATS bileaflet valve in our institution. In the past 6 years, 69 patients received valve replacement with an ATS valve. We assessed the changes of serum lactate dehydrogenase (LDH) level in the hospital, and the valve's closing sound. The serum LDH level had almost normalized one week postoperatively and they have maintained normal levels since then. According to the questionnaire about the valvular sound at a random period after surgery, it was unnoticeable in 61 (88.4%) of the patients with ATS valve. In the 8 patients (12.6%) who recognized the valve sound, 7 of them were reoperation cases. As to the frequency analysis for the valve's closing sound, the sound peak was indicated at around 1.2 kHz in the patients with ATS valves. In patients with St. Jude Medical (SJM) valves, it appeared not only around 1.2 kHz but also around 2 to 7 kHz. Postoperative cerebral infarction was complicated in one patient. Mortality occurred in 4 (5.7%) of the patients with ATS valves. The follow up periods were from one to 66 months. Thromboembolic event free and actuarial survival rate in the patients with ATS valves were 98.6% and 94.2%, respectively. These results indicated that the ATS valve is considered to be a safe valve and mid-term follow-up shows excellent results in terms of the patients quality of life.