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European Journal of Cardio-Thoracic Surgery, Vol 7, 84-90, Copyright © 1993 by European Association for Cardio-thoracic Surgery

ARTICLES

Six-year follow-up after heart valve replacement with the Edwards Duromedics bileaflet prosthesis

A Moritz, W Klepetko, S Rodler, A Foger, W Schreiner, F Grabenwoger and E Wolner
Second Surgical Department, University of Vienna, Wien, Austria.

The Duromedics Edwards valve (DE) was designed with a self-irrigating hinge mechanism to reduce the rate of thromboembolic complications. This report presents a prospective follow-up of patients after valve replacement with this prosthesis in a university hospital. Five hundred seven patients had DE prostheses implanted in the aortic (n = 268), mitral (n = 183) or aortic and mitral positions (n = 56). The perioperative mortality was 6.9%. Follow-up was 98% complete, comprising 2009 patient years for a mean follow-up of 48 months: (range 27-84). The actuarial freedom from complications is calculated as follows (linearized rates in parentheses): late mortality 81.0 +/- 2.3% (3.4%/patient year), thromboembolism 93.5 +/- 1.5% (1.1%/patient year), anticoagulation-related hemorrhage 89.5 +/- 2.0% (1.9%/patient year), prosthetic valve endocarditis 96.0 +/- 1.2% (0.7%/patient year), valve- related mortality 93 +/- 1.8% (1.5%/patient year), valve failure 89 +/- 2.0% (2%/patient year), treatment failure 88.0 +/- 2.0% (2.2%/patient year) and all valve-related morbidity and mortality 74.0 +/- 2.8% (5.3%/patient year). Two events of leaflet escape were observed in the study group (0.09%/patient year). Both patients were reoperated successfully. Mechanical hemolysis was subclinical in all cases. The DE shows a complication rate comparable to other modern mechanical valve prostheses. After solving the problem of durability, reconsideration of this valve is worthwhile due to its low risk of thromboembolic complications.

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				W. B. Hemmer, M. Doss, A. Hannekum, and X. Kapfer Leaflet escape in a TEKNA and an original duromedics bileaflet valve Ann. Thorac. Surg., March 1, 2000; 69(3): 942 - 944. [Abstract] [Full Text] [PDF]

				B. K. Podesser, G. Khuenl-Brady, E. Eigenbauer, S. Roedler, A. Schmiedberger, E. Wolner, and A. Moritz Long-term results of heart valve replacement with the Edwards Duromedics bileaflet prosthesis: A prospective ten-year clinical follow-up J. Thorac. Cardiovasc. Surg., May 1, 1998; 115(5): 1121 - 1129. [Abstract] [Full Text] [PDF]