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J.Jpn. Surg. Soc.. 90(9): 1525-1528, 1989


Report on the annual meeting

THE CLINICAL CRITERIA FOR CARPENTIER-EDWARDS BIOPROSTHESIS IN THE MITRAL POSITION

Department of Thoracic and Cardiovascular Surgery, Kobe City General Hospital, Kobe, Japan

Toyo Shomura, Sunao Nishiuchi, Koji Okamoto, Jun Sono, Yukikatsu Okada, Satoru Miyamoto, Kiyoshi Tatemichi

This is a comparative study of late results of mitral valve replacement between Carpentier-Edwards (C-E) and Björk-Shiley (B-S) valve prosthesis. The purpose of this study is to clarify the clinical criteria for C-E valve.
C-E valve was implanted in 202 patients. The mean follow up period was 5.8 years and the longest one was 11 years. For B-S valve, it was 132 patients, 5.3 years and 17 years, respectively. With respect to the incidence of thromboembolic episodes, in spite of no anticoagulant therapy in the C-E group, there was no statistical difference between the C-E and the B-S groups. The incidence of valve related complication in the C-E group was significantly lower than that in the B-S group 5 years postoperatively. But that in the B-S group was significantly low 10 years postoperatively. Since the over 60 years old patients in the C-E group had low incidence of primary tissue failure, over ten years durability might be secured.
In conclusion, the present clinical criteria for C-E valve should be as follows : 1) the patient older than 65 years, 2) the patient with contraindication for anticoagulant therapy, 3) the woman who desires pregnancy and 4) the patient with hemorrhagic diathesis caused by cardiac cachexia, liver cirrhosis and so on.


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