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Long-term experience with the Ionescu-Shiley pericardial valve
R G Masters1, V M Walley, A L Pipe
1Department of Surgery, University of Ottawa Heart Institute, Ottawa Civic Hospital, Canada.
The Annals of Thoracic Surgery
|August 1, 1995
Summary
The Ionescu-Shiley valve shows moderate long-term durability, with survival rates around 44-46% at 14 years. Structural failures, primarily leaflet tears, necessitate reoperation in a significant portion of patients, impacting valve longevity.
Area of Science:
- Cardiovascular Surgery
- Biomaterials Science
- Medical Device Durability
Background:
- The Ionescu-Shiley valve is a prosthetic device used in heart valve replacement surgeries.
- Long-term durability is a critical factor in the success of prosthetic heart valves.
- Understanding failure modes and reoperation rates is essential for patient management.
Purpose of the Study:
- To evaluate the long-term durability and performance of the Ionescu-Shiley valve.
- To analyze survival and reoperation rates following aortic and mitral valve replacement.
- To identify factors contributing to structural failure and the need for reoperation.
Main Methods:
- Retrospective analysis of 780 patients who underwent aortic valve replacement (AVR) or mitral valve replacement (MVR) with the Ionescu-Shiley valve.
- Data collected up to 1988, including patient survival, reoperation events, and valve structural integrity.
- Actuarial survival and freedom from reoperation rates were calculated for AVR and MVR.
Main Results:
- Actuarial survival at 10 years was 62% +/- 3% for AVR and 58% +/- 4% for MVR.
- Reoperation was required in 197 patients, with 85% exhibiting structural failure, predominantly leaflet tears.
- Freedom from reoperation at 10 years was 58% +/- 3% for AVR and 62% +/- 5% for MVR.
Conclusions:
- The Ionescu-Shiley valve demonstrates moderate long-term durability, with significant rates of structural failure, particularly leaflet tears.
- Leaflet tears were more common after AVR and in low-profile valves, though profile type did not significantly affect reoperation rates.
- The findings highlight the need for ongoing monitoring and potential for reoperation in patients with this valve prosthesis.