CLINICAL STUDY: CARDIAC SURGERY
Outcomes 15 years after valve replacement with a mechanical versus a bioprosthetic valve: final report of the Veterans Affairs randomized trial
Karl Hammermeister, MD, FACC*,
Gulshan K. Sethi, MD, FACC ,
William G. Henderson, PhD ,
Frederick L. Grover, MD, FACC*,
Charles Oprian, PhD and
Shahbudin H. Rahimtoola, MB, FRCP, MACP, MACC
* Denver VA Medical Center and University of Colorado Health Sciences Center, Denver, Colorado, USA
Tucson VA Medical Center and University of Arizona Health Sciences Center, Tucson, Arizona, USA
Hines VA Medical Center, Hines, Illinois, USA
LAC and USC Medical Center, University of Southern California, Los Angeles, California, USA
Manuscript received December 28, 1999;
revised manuscript received April 4, 2000,
accepted May 4, 2000.
Reprint requests and correspondence: William G. Henderson, VA Cooperative Studies Program Coordinating Center (151K), P. O. Box 5000, Hines VA Hospital, Hines, Illinois 60141-5151
OBJECTIVES
The goal of this study was to compare long-term survival and valve-related complications between bioprosthetic and mechanical heart valves.
BACKGROUND
Different heart valves may have different patient outcomes.
METHODS
Five hundred seventy-five patients undergoing single aortic valve replacement (AVR) or mitral valve replacement (MVR) at 13 VA medical centers were randomized to receive a bioprosthetic or mechanical valve.
RESULTS
By survival analysis at 15 years, all-cause mortality after AVR was lower with the mechanical valve versus bioprosthesis (66% vs. 79%, p = 0.02) but not after MVR. Primary valve failure occurred mainly in patients <65 years of age (bioprosthesis vs. mechanical, 26% vs. 0%, p < 0.001 for AVR and 44% vs. 4%, p = 0.0001 for MVR), and in patients  65 years after AVR, primary valve failure in bioprosthesis versus mechanical valve was 9 ± 6% versus 0%, p = 0.16. Reoperation was significantly higher for bioprosthetic AVR (p = 0.004). Bleeding occurred more frequently in patients with mechanical valve. There were no statistically significant differences for other complications, including thromboembolism and all valve-related complications between the two randomized groups.
CONCLUSIONS
At 15 years, patients undergoing AVR had a better survival with a mechanical valve than with a bioprosthetic valve, largely because primary valve failure was virtually absent with mechanical valve. Primary valve failure was greater with bioprosthesis, both for AVR and MVR, and occurred at a much higher rate in those aged <65 years; in those aged 65 years, primary valve failure after AVR was not significantly different between bioprosthesis and mechanical valve. Reoperation was more common for AVR with bioprosthesis. Thromboembolism rates were similar in the two valve prostheses, but bleeding was more common with a mechanical valve.
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Abbreviations and Acronyms
| | AVR | = aortic valve replacement | | MVR | = mitral valve replacement | | VA | = Veterans Affairs |
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87(4):
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8(4):
449 - 453.
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E. Balaras, K.S. Cha, B. P. Griffith, and J. S. Gammie
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137(3):
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|
|
|
|
|
|
|
P. Pibarot and J. G. Dumesnil
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February 24, 2009;
119(7):
1034 - 1048.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. M. Sheikh, A. M. Elhenawy, M. Maganti, S. Armstrong, T. E. David, and C. M. Feindel
Outcomes of surgical intervention for isolated active mitral valve endocarditis.
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January 1, 2009;
137(1):
110 - 116.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Vahanian, B. Iung, L. Piérard, R. Dion, and J. Pepper
CHAPTER 21 Valvular Heart Disease
ESC Textbook of Cardiovascular Medicine,
January 1, 2009;
2(1):
med-9780199566990-chapter - med-9780199566990-chapter.
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[Full Text]
[PDF]
|
|
|
|
|
|
|
G. W. Fischer and D. H. Adams
Real-time three-dimensional TEE-guided repair of a paravalvular leak after mitral valve replacement
Eur J Echocardiogr,
November 1, 2008;
9(6):
868 - 869.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
2006 WRITING COMMITTEE MEMBERS, R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, et al.
2008 Focused Update Incorporated Into the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons
Circulation,
October 7, 2008;
118(15):
e523 - e661.
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, P. T. O'Gara, et al.
2008 Focused Update Incorporated Into the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons
J. Am. Coll. Cardiol.,
September 23, 2008;
52(13):
e1 - e142.
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. A. Yankah, M. Pasic, M. Musci, J. Stein, C. Detschades, H. Siniawski, and R. Hetzer
Aortic valve replacement with the Mitroflow pericardial bioprosthesis: Durability results up to 21 years
J. Thorac. Cardiovasc. Surg.,
September 1, 2008;
136(3):
688 - 696.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E B Schelbert, M S Vaughan-Sarrazin, K F Welke, and G E Rosenthal
Valve type and long-term outcomes after aortic valve replacement in older patients
Heart,
September 1, 2008;
94(9):
1181 - 1188.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. L. Thompson, T. M. Sundt, M. E. Sarano, P. J. Santrach, and H. V. Schaff
In-Patient International Normalized Ratio Self-Testing Instruction After Mechanical Heart Valve Implantation
Ann. Thorac. Surg.,
June 1, 2008;
85(6):
2046 - 2050.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. L. Brown, H. V. Schaff, B. D. Lahr, C. J. Mullany, T. M. Sundt, J. A. Dearani, C. G. McGregor, and T. A. Orszulak
Aortic valve replacement in patients aged 50 to 70 years: Improved outcome with mechanical versus biologic prostheses.
J. Thorac. Cardiovasc. Surg.,
April 1, 2008;
135(4):
878 - 884.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. de Vincentiis, A. B. Kunkl, S. Trimarchi, P. Gagliardotto, A. Frigiola, L. Menicanti, and M. Di Donato
Aortic Valve Replacement in Octogenarians: Is Biologic Valve the Unique Solution?
Ann. Thorac. Surg.,
April 1, 2008;
85(4):
1296 - 1301.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Russo, F. Grigioni, J.-F. Avierinos, W. K. Freeman, R. Suri, H. Michelena, R. Brown, T. M. Sundt, and M. Enriquez-Sarano
Thromboembolic Complications After Surgical Correction of Mitral Regurgitation: Incidence, Predictors, and Clinical Implications
J. Am. Coll. Cardiol.,
March 25, 2008;
51(12):
1203 - 1211.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Eitz, S. Schenk, D. Fritzsche, A. Bairaktaris, O. Wagner, H. Koertke, and R. Koerfer
International Normalized Ratio Self-Management Lowers the Risk of Thromboembolic Events After Prosthetic Heart Valve Replacement
Ann. Thorac. Surg.,
March 1, 2008;
85(3):
949 - 955.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. A.C. Ennker, A. A. Albert, U. P. Rosendahl, I. C. Ennker, F. Dalladaku, and I. Florath
Ten-Year Experience With Stentless Aortic Valves: Full-Root Versus Subcoronary Implantation
Ann. Thorac. Surg.,
February 1, 2008;
85(2):
445 - 453.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. Flameng, B. Meuris, G. De Visscher, C. Cunanan, E. Lane, E. Verbeken, P. Herijgers, and M.-C. Herregods
Trilogy Pericardial Valve: Hemodynamic Performance and Calcification in Adolescent Sheep
Ann. Thorac. Surg.,
February 1, 2008;
85(2):
587 - 592.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. El Oakley, P. Kleine, and D. S. Bach
Choice of Prosthetic Heart Valve in Today's Practice
Circulation,
January 15, 2008;
117(2):
253 - 256.
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. F. Padera Jr. and F. J. Schoen
Pathology of Cardiac Surgery
Card. Surg. Adult,
January 1, 2008;
3(2008):
111 - 178.
[Full Text]
|
|
|
|
|
|
|
M. Enriquez-Sarano, V. T. Nkomo, and H. Michelena
Principles and Practice of Echocardiography in Cardiac Surgery
Card. Surg. Adult,
January 1, 2008;
3(2008):
315 - 348.
[Full Text]
|
|
|
|
|
|
|
N. D. Desai and G. T. Christakis
Bioprosthetic Aortic Valve Replacement: Stented Pericardial and Porcine Valves
Card. Surg. Adult,
January 1, 2008;
3(2008):
857 - 894.
[Full Text]
|
|
|
|
|
|
|
T. E. David
Surgical Treatment of Aortic Valve Endocarditis
Card. Surg. Adult,
January 1, 2008;
3(2008):
949 - 956.
[Full Text]
|
|
|
|
|
|
|
T. Gudbjartsson, T. Absi, and S. Aranki
Mitral Valve Replacement
Card. Surg. Adult,
January 1, 2008;
3(2008):
1031 - 1068.
[Full Text]
|
|
|
|
|
|
|
J. E. Mayer
Tissue Engineering for Cardiac Valve Surgery
Card. Surg. Adult,
January 1, 2008;
3(2008):
1649 - 1656.
[Full Text]
|
|
|
|
|
|
|
J. Dunning, R.J. Graham, J. Thambyrajah, M.J. Stewart, S.W.H. Kendall, and S. Hunter
Stentless vs. stented aortic valve bioprostheses: a prospective randomized controlled trial
Eur. Heart J.,
October 1, 2007;
28(19):
2369 - 2374.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Ruel, V. Chan, P. Bedard, A. Kulik, L. Ressler, B. K. Lam, F. D. Rubens, W. Goldstein, P. J. Hendry, R. G. Masters, et al.
Very Long-Term Survival Implications of Heart Valve Replacement With Tissue Versus Mechanical Prostheses in Adults <60 Years of Age
Circulation,
September 11, 2007;
116(11_suppl):
I-294 - I-300.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. T Butcher and R. M Nerem
Valvular endothelial cells and the mechanoregulation of valvular pathology
Phil Trans R Soc B,
August 29, 2007;
362(1484):
1445 - 1457.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. T Butcher and R. R Markwald
Valvulogenesis: the moving target
Phil Trans R Soc B,
August 29, 2007;
362(1484):
1489 - 1503.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. Kunadian, K. Vijayalakshmi, A. R. Thornley, M. A. de Belder, S. Hunter, S. Kendall, R. Graham, M. Stewart, J. Thambyrajah, and J. Dunning
Meta-Analysis of Valve Hemodynamics and Left Ventricular Mass Regression for Stentless Versus Stented Aortic Valves
Ann. Thorac. Surg.,
July 1, 2007;
84(1):
73 - 78.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Prasongsukarn, W. E. Jamieson, E. Germann, F. Chan, and S. V Lichtenstein
Aortic and Mitral Prosthetic Valve Replacement in Age Groups 61 65 & 66 70 Years
Asian Cardiovasc Thorac Ann,
April 1, 2007;
15(2):
127 - 133.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Authors/Task Force Members, A. Vahanian, H. Baumgartner, J. Bax, E. Butchart, R. Dion, G. Filippatos, F. Flachskampf, R. Hall, B. Iung, et al.
Guidelines on the management of valvular heart disease: The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology
Eur. Heart J.,
January 26, 2007;
(2007)
ehl428v1.
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. Lau, W.R. E. Jamieson, C. Hughes, E. Germann, and F. Chan
What Prosthesis Should Be Used at Valve Re-Replacement After Structural Valve Deterioration of a Bioprosthesis?
Ann. Thorac. Surg.,
December 1, 2006;
82(6):
2123 - 2132.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. L. Grunkemeier, R. Jin, and A. Starr
Prosthetic heart valves: objective performance criteria versus randomized clinical trial.
Ann. Thorac. Surg.,
September 1, 2006;
82(3):
776 - 780.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Rizzoli, S. Mirone, P. Ius, E. Polesel, T. Bottio, L. Salvador, C. Zussa, G. Gerosa, and C. Valfre
Fifteen-year results with the Hancock II valve: A multicenter experience.
J. Thorac. Cardiovasc. Surg.,
September 1, 2006;
132(3):
602 - 609.e4.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, P. T. O'Gara, et al.
ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) Developed in Collaboration With the Society of Cardiovascular Anesthesiologists Endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons
J. Am. Coll. Cardiol.,
August 1, 2006;
48(3):
e1 - e148.
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, P. T. O'Gara, et al.
ACC/AHA 2006 Practice Guidelines for the Management of Patients With Valvular Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) Developed in Collaboration With the Society of Cardiovascular Anesthesiologists Endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons
J. Am. Coll. Cardiol.,
August 1, 2006;
48(3):
598 - 675.
[Full Text]
[PDF]
|
|
|
|
|
|
|
O. Lund and M. Bland
Risk-corrected impact of mechanical versus bioprosthetic valves on long-term mortality after aortic valve replacement
J. Thorac. Cardiovasc. Surg.,
July 1, 2006;
132(1):
20 - 26.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Sodian, C. Lueders, L. Kraemer, W. Kuebler, M. Shakibaei, B. Reichart, S. Daebritz, and R. Hetzer
Tissue Engineering of Autologous Human Heart Valves Using Cryopreserved Vascular Umbilical Cord Cells
Ann. Thorac. Surg.,
June 1, 2006;
81(6):
2207 - 2216.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
V. Chan, W.R.E. Jamieson, E. Germann, F. Chan, R.T. Miyagishima, L.H. Burr, M.T. Janusz, H. Ling, and G.J. Fradet
Performance of bioprostheses and mechanical prostheses assessed by composites of valve-related complications to 15 years after aortic valve replacement
J. Thorac. Cardiovasc. Surg.,
June 1, 2006;
131(6):
1267 - 1273.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Additional Information
JAMA,
March 15, 2006;
295(11):
E1 - E6.
[Full Text]
[PDF]
|
|
|
|
|
|
|
Are allografts the biologic valve of choice for aortic valve replacement in nonelderly patients? Comparison of explantation for structural valve deterioration of allograft and pericardial prostheses.
J. Thorac. Cardiovasc. Surg.,
March 1, 2006;
131(3):
558 - 564.e4.
|
|
|
|
|
|
|
S. H. Rahimtoola
The Year in Valvular Heart Disease
J. Am. Coll. Cardiol.,
January 17, 2006;
47(2):
427 - 439.
[Full Text]
[PDF]
|
|
|
|
|
|
|
U. Ozyurda, A. R. Akar, O. Uymaz, M. Oguz, M. Ozkan, C. Yildirim, A. Aslan, and R. Tasoz
Early clinical experience with the On-X prosthetic heart valve
Interactive CardioVascular and Thoracic Surgery,
December 1, 2005;
4(6):
588 - 594.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. T. L. Hu and J. F. Malouf
75-Year-Old Man With Progressive Shortness of Breath on Exertion
Mayo Clin. Proc.,
December 1, 2005;
80(12):
1651 - 1654.
[PDF]
|
|
|
|
|
|
|
C. E. Ruiz, M. Iemura, S. Medie, P. Varga, W. G. Van Alstine, S. Mack, A. Deligio, N. Fearnot, U. H. Beier, D. Pavcnik, et al.
Transcatheter placement of a low-profile biodegradable pulmonary valve made of small intestinal submucosa: A long-term study in a swine model
J. Thorac. Cardiovasc. Surg.,
August 1, 2005;
130(2):
477 - 484.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
I Florath, A Albert, U Rosendahl, T Alexander, I C Ennker, and J Ennker
Mid term outcome and quality of life after aortic valve replacement in elderly people: mechanical versus stentless biological valves
Heart,
August 1, 2005;
91(8):
1023 - 1029.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. V. Freeman and C. M. Otto
Spectrum of Calcific Aortic Valve Disease: Pathogenesis, Disease Progression, and Treatment Strategies
Circulation,
June 21, 2005;
111(24):
3316 - 3326.
[Full Text]
[PDF]
|
|
|
|
|
|
|
W.R.E. Jamieson, O. von Lipinski, R.T. Miyagishima, L.H. Burr, M.T. Janusz, H. Ling, G.J. Fradet, F. Chan, and E. Germann
Performance of bioprostheses and mechanical prostheses assessed by composites of valve-related complications to 15 years after mitral valve replacement
J. Thorac. Cardiovasc. Surg.,
June 1, 2005;
129(6):
1301 - 1308.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Wheatley and M. Will
Mitral valve replacement with mechanical or bioprosthetic valve
MMCTS,
April 25, 2005;
2005(0425):
1024.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Gjertsson, K. Caidahl, M. Farasati, A. Oden, and O. Bech-Hanssen
Preoperative moderate to severe diastolic dysfunction: A novel Doppler echocardiographic long-term prognostic factor in patients with severe aortic stenosis
J. Thorac. Cardiovasc. Surg.,
April 1, 2005;
129(4):
890 - 896.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. J. Schoen and R. J. Levy
Calcification of Tissue Heart Valve Substitutes: Progress Toward Understanding and Prevention
Ann. Thorac. Surg.,
March 1, 2005;
79(3):
1072 - 1080.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. D. Potter, T. M. Sundt III, K. J. Zehr, J. A. Dearani, R. C. Daly, C. J. Mullany, C. G.A. McGregor, F. J. Puga, H. V. Schaff, and T. A. Orszulak
Operative risk of reoperative aortic valve replacement
J. Thorac. Cardiovasc. Surg.,
January 1, 2005;
129(1):
94 - 103.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. A. Mangi and D. F. Torchiana
A technique for repair of mitral paravalvular leak
J. Thorac. Cardiovasc. Surg.,
November 1, 2004;
128(5):
771 - 772.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J P A Puvimanasinghe, J J M Takkenberg, M B Edwards, M J C Eijkemans, E W Steyerberg, L A van Herwerden, K M Taylor, G L Grunkemeier, J D F Habbema, and A J J C Bogers
Comparison of outcomes after aortic valve replacement with a mechanical valve or a bioprosthesis using microsimulation
Heart,
October 1, 2004;
90(10):
1172 - 1178.
[Abstract]
[Full Text]
[PDF]
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S. Rahimtoola
Reply
J. Am. Coll. Cardiol.,
August 4, 2004;
44(3):
667 - 668.
[Full Text]
[PDF]
|
|
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|
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A. Sedrakyan, P. Hebert, V. Vaccarino, A. D. Paltiel, J. A. Elefteriades, J. Mattera, Z. Lin, S. A. Roumanis, and H. M. Krumholz
Quality of life after aortic valve replacement with tissue and mechanical implants
J. Thorac. Cardiovasc. Surg.,
August 1, 2004;
128(2):
266 - 272.
[Abstract]
[Full Text]
[PDF]
|
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J. T. Butcher, A. M. Penrod, A. J. Garcia, and R. M. Nerem
Unique Morphology and Focal Adhesion Development of Valvular Endothelial Cells in Static and Fluid Flow Environments
Arterioscler Thromb Vasc Biol,
August 1, 2004;
24(8):
1429 - 1434.
[Abstract]
[Full Text]
[PDF]
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J. Bergler-Klein, U. Klaar, M. Heger, R. Rosenhek, G. Mundigler, H. Gabriel, T. Binder, R. Pacher, G. Maurer, and H. Baumgartner
Natriuretic Peptides Predict Symptom-Free Survival and Postoperative Outcome in Severe Aortic Stenosis
Circulation,
May 18, 2004;
109(19):
2302 - 2308.
[Abstract]
[Full Text]
[PDF]
|
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B. Iung, J. Rousseau-Paziaud, B. Cormier, E. Garbarz, O. Fondard, E. Brochet, C. Acar, J.-P. Couetil, U. Hvass, and A. Vahanian
Contemporary results of mitral valve repair for infective endocarditis
J. Am. Coll. Cardiol.,
February 4, 2004;
43(3):
386 - 392.
[Abstract]
[Full Text]
[PDF]
|
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S. H. Rahimtoola
The year in valvular heart disease
J. Am. Coll. Cardiol.,
February 4, 2004;
43(3):
491 - 504.
[Full Text]
[PDF]
|
|
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D. S. Bach
Choice of prosthetic heart valves:update for the next generation
J. Am. Coll. Cardiol.,
November 19, 2003;
42(10):
1717 - 1719.
[Abstract]
[Full Text]
[PDF]
|
|
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S. H. Rahimtoola
The next generation of prosthetic heart valves needs a proven track record of patient outcomes at >=15 to 20 years
J. Am. Coll. Cardiol.,
November 19, 2003;
42(10):
1720 - 1721.
[Abstract]
[Full Text]
[PDF]
|
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G. Nollert, J. Miksch, E. Kreuzer, and B. Reichart
Risk factors for atherosclerosis and the degeneration of pericardial valves after aortic valve replacement
J. Thorac. Cardiovasc. Surg.,
October 1, 2003;
126(4):
965 - 968.
[Abstract]
[Full Text]
[PDF]
|
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B. Iung, G. Baron, E. G. Butchart, F. Delahaye, C. Gohlke-Barwolf, O. W. Levang, P. Tornos, J.-L. Vanoverschelde, F. Vermeer, E. Boersma, et al.
A prospective survey of patients with valvular heart disease in Europe: The Euro Heart Survey on Valvular Heart Disease
Eur. Heart J.,
July 1, 2003;
24(13):
1231 - 1243.
[Abstract]
[Full Text]
[PDF]
|
|
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H Oxenham, P Bloomfield, D J Wheatley, R J Lee, J Cunningham, R J Prescott, and H C Miller
Twenty year comparison of a Bjork-Shiley mechanical heart valve with porcine bioprostheses
Heart,
July 1, 2003;
89(7):
715 - 721.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Moneta, E. Villa, and F. Donatelli
An alternative technique for non-infective paraprosthetic leakage repair
Eur. J. Cardiothorac. Surg.,
June 1, 2003;
23(6):
1074 - 1075.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
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G Hanania
Which heart valve prosthesis for patients aged between 60 and 70 years?
Heart,
May 1, 2003;
89(5):
481 - 482.
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. H. Rahimtoola
Choice of prosthetic heart valve for adult patients
J. Am. Coll. Cardiol.,
March 19, 2003;
41(6):
893 - 904.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Doss, S. Martens, J.P. Wood, T. Aybek, P. Kleine, G. Wimmer Greinecker, and A. Moritz
Performance of stentless versus stented aortic valve bioprostheses in the elderly patient: a prospective randomized trial
Eur. J. Cardiothorac. Surg.,
March 1, 2003;
23(3):
299 - 304.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. J. Schoen and R. F. Padera Jr.
Cardiac Surgical Pathology
Card. Surg. Adult,
January 1, 2003;
2(2003):
119 - 185.
[Full Text]
|
|
|
|
|
|
|
N. D. Desai and G. T. Christakis
Stented Mechanical/Bioprosthetic Aortic Valve Replacement
Card. Surg. Adult,
January 1, 2003;
2(2003):
825 - 856.
[Full Text]
|
|
|
|
|
|
|
T. E. David
Surgical Treatment of Aortic Valve Endocarditis
Card. Surg. Adult,
January 1, 2003;
2(2003):
857 - 866.
[Full Text]
|
|
|
|
|
|
|
T. Gudbjartsson, S. Aranki, and L. H. Cohn
Mechanical/Bioprosthetic Mitral Valve Replacement
Card. Surg. Adult,
January 1, 2003;
2(2003):
951 - 986.
[Full Text]
|
|
|
|
|
|
|
C. W. Akins, A. D. Hilgenberg, G. J. Vlahakes, T. E. MacGillivray, D. F. Torchiana, and J. C. Madsen
Results of bioprosthetic versus mechanical aortic valve replacement performed with concomitant coronary artery bypass grafting
Ann. Thorac. Surg.,
October 1, 2002;
74(4):
1098 - 1106.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. H. Rahimtoola, A. Durairaj, A. Mehra, and I. Nuno
Current Evaluation and Management of Patients With Mitral Stenosis
Circulation,
September 3, 2002;
106(10):
1183 - 1188.
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Bloomfield
Choice of heart valve prosthesis
Heart,
June 1, 2002;
87(6):
583 - 589.
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. A. Carabello
Evaluation and Management of Patients With Aortic Stenosis
Circulation,
April 16, 2002;
105(15):
1746 - 1750.
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. G. Butchart, N. Payne, H.-H. Li, K. Buchan, K. Mandana, and G. L. Grunkemeier
Better anticoagulation control improves survival after valve replacement
J. Thorac. Cardiovasc. Surg.,
April 1, 2002;
123(4):
715 - 723.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
G. Cohen, G. T. Christakis, C. D. Joyner, C. D. Morgan, M. Tamariz, N. Hanayama, H. Mallidi, J.P. Szalai, M. Katic, V. Rao, et al.
Are stentless valves hemodynamically superior to stented valves? A prospective randomized trial
Ann. Thorac. Surg.,
March 1, 2002;
73(3):
767 - 778.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. L. Weind, C. G. Ellis, and D. R. Boughner
Aortic valve cusp vessel density: Relationship with tissue thickness
J. Thorac. Cardiovasc. Surg.,
February 1, 2002;
123(2):
333 - 340.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. H Rahimtoola
VALVE DISEASE: Should patients with asymptomatic mild or moderate aortic stenosis undergoing coronary artery bypass surgery also have valve replacement for their aortic stenosis?
Heart,
March 1, 2001;
85(3):
337 - 341.
[Full Text]
|
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