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Mitral valve replacement with a turtleneck-disc prosthesis
Insights
This study evaluated the Harken (Magovern) disc valve in 100 patients over 5 years. While operative mortality was low, late deaths were higher in severe heart failure patients and those with multiple valve replacements.
Area of Science:
- Cardiovascular Surgery
- Biomaterials Science
- Clinical Outcomes Research
Background:
- The Magovern-Harken valve is a specific type of prosthetic heart valve.
- Continuous suture techniques are employed for valve implantation.
- Long-term outcomes of prosthetic valves are crucial for patient management.
Purpose of the Study:
- To report the 5-year experience with the Magovern-Harken disc valve in 100 patients.
- To analyze factors influencing operative and late mortality.
- To assess the incidence of thromboembolic complications and valve-related issues.
Main Methods:
- Prospective evaluation of 100 patients receiving the Magovern-Harken valve.
- Implantation via continuous suture technique in the atrioventricular position.
- Follow-up for 5 years to assess mortality, complications, and valve function.
Main Results:
- Operative mortality was 7%, and late mortality was 8%.
- Factors like age, pulmonary hypertension, and reoperation did not affect operative mortality.
- Late mortality was significantly higher in New York Heart Association Class IV patients and those undergoing multiple valve replacements.
- Thromboembolic complications occurred in 7% of patients; no peribasilar leaks or dehiscences were observed.
Conclusions:
- The Magovern-Harken disc valve demonstrates acceptable early and late survival rates.
- Patient functional status and the extent of valve surgery are critical determinants of long-term outcomes.
- The valve appears safe regarding peribasilar complications, with a manageable rate of thromboembolic events.
Abstract:
A 5 year experience in 100 patients with a turtleneck-cuff (Magovern) disc valve (Harken) is presented. The prosthesis was inserted into the atrioventricular position by a continuous suture technique. The operative mortality rate was 7 per cent and the late mortality rate, 8 per cent. Age, functional classification, multiple valve replacement, pulmonary hypertension, and reoperation did not influence the operative mortality rate. However, the incidence of late death was much higher among patients in Class IV than in Class III and was also greater when more than one valve was replaced. The incidence of combined early and late thromboembolic complications was 7 per cent. Peribasilar leaks or valve dehiscences were not encountered.