CryoLife-O'Brien Stentless Valve: 10-Year Results of 402 Implants

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Presentation transcript:

CryoLife-O'Brien Stentless Valve: 10-Year Results of 402 Implants Mark F. O'Brien, FRACS, Michael A.H. Gardner, FRACS, Bruce Garlick, FRACS, Homayoun Jalali, MD, Julie A. Gordon, RN, Sarah L. Whitehouse, PhD, Wendy E. Strugnell, BAppSc, Richard Slaughter, FRANZCR The Annals of Thoracic Surgery Volume 79, Issue 3, Pages 757-766 (March 2005) DOI: 10.1016/j.athoracsur.2004.08.057 Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig. 1 Supra-annular implantation (left) maximizes the effective orifice compared to the reduced orifice with the intra-annular implantation (right). With complete valve excision and thorough annular decalcification, the exposed annulus would appear capable of having its ability “to dilate” restored. (LV = left ventricle.) The Annals of Thoracic Surgery 2005 79, 757-766DOI: (10.1016/j.athoracsur.2004.08.057) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig. 2 The aortic valve annulus is seen as an area of low signal intensity beneath the valve on steady-state free precession imaging. The Annals of Thoracic Surgery 2005 79, 757-766DOI: (10.1016/j.athoracsur.2004.08.057) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 (A) Phase contrast images are acquired directly through the annulus, orthogonal to the left ventricular outflow tract (white line); (B) resultant magnitude; and (C) phase images of the aortic valve annulus. The Annals of Thoracic Surgery 2005 79, 757-766DOI: (10.1016/j.athoracsur.2004.08.057) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 The mean cross-sectional area of the aortic valve annulus (top) and the mean flow volumes (bottom) were calculated at 30 intervals throughout the cardiac cycle and plotted against each point of the cardiac cycle. The Annals of Thoracic Surgery 2005 79, 757-766DOI: (10.1016/j.athoracsur.2004.08.057) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Actuarial patient survival expresses the number of patients at risk more than 10 years. The actual number of deaths more than 10 years and the actuarial freedom at 8 years is expressed with 95% confidence limits. (AVR = aortic valve replacement.) The Annals of Thoracic Surgery 2005 79, 757-766DOI: (10.1016/j.athoracsur.2004.08.057) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 6 Actuarial freedom from thromboembolism of all grades of severity (see Table 2). Depiction as in Figure 5. (AVR = aortic valve replacement.) The Annals of Thoracic Surgery 2005 79, 757-766DOI: (10.1016/j.athoracsur.2004.08.057) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 7 Actuarial freedom from thromboembolism (all grades of severity) causing a permanent disability (see Table 2). Depiction as in Figure 5. *includes 1 death from mesenteric artery embolism. (AVR = aortic valve replacement.) The Annals of Thoracic Surgery 2005 79, 757-766DOI: (10.1016/j.athoracsur.2004.08.057) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 8 Actuarial freedom from endocarditis. The nine episodes all occurred within the first 5 years after AVR (see Table 2). Depiction as in Figure 5. (AVR = aortic valve replacement.) The Annals of Thoracic Surgery 2005 79, 757-766DOI: (10.1016/j.athoracsur.2004.08.057) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 9 Actuarial freedom from reoperation due to all causes (see Table 2). Depiction as in Figure 5. (AVR = aortic valve replacement.) The Annals of Thoracic Surgery 2005 79, 757-766DOI: (10.1016/j.athoracsur.2004.08.057) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 10 Actuarial freedom from valve explantation at 8 years was 97.8% ± 2.1%. Depiction as in Figure 5. (AVR = aortic valve replacement.) The Annals of Thoracic Surgery 2005 79, 757-766DOI: (10.1016/j.athoracsur.2004.08.057) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions