CARDIAC VALVE REPLACEMENT CARDIAC VALVE REPLACEMENT CURRENT STATUS PROCEEDINGS OF THE FOURTH INTERNATIONAL SYMPOSIUM ON THE ST. JUDE MEDICAL@ VALVE, MARCH 11-14, 1984 JACK M. MATLOFF, EDITOR UI " MARTINUS NIJHOFF PUBLISHING A MEMBER OF THE KLUWER ACADEMIC PUBLISHERS GROUP BOSTON DORDRECHT LANCASTER Copyright 1985 @ by Martinus Nijhoff Publishing, Boston Softcover reprint of the hardcover 1st edition 1985 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, mechanical, photocopying, recording, or otherwise, without written permission of the publisher, Martinus Nijhoff Publishing, 190 Old Derby Street, Hingham, Massachusetts 02043. Distrihutors for North America: Distrihutors for all other countries: Kluwer Academic Publishers Kluwer Academic Publishers Group 190 Old Derby Street Distribution Centre Hingham, MA 02043 P.O. Box 322 3300 AH Dordrecht The Netherlands Library of Congress Cataloging in Publication Data International Symposium on the St. Jude Medical Valve (4th: 1984 : Montego Bay, Jamaica) Cardiac valve replacement. Includes bibliographies. 1. Heart valve prosthesis-Congresses. 1. Matloff, Jack M. II. Title. III. Title: St. Jude Medical Valve. [DNLM: 1. Heart Valve Prosthesis- congresses. W3 IN924NU 4th 1984c I WG 169 1608 1984c] RD598.I54 1984 617'.412 85-5059 ISBN-13: 978-1-4612-9629-4 e-ISBN-I3: 978-1-4613-2610-4 DOl: 10.1007/978-1-4613-2610-4 CONTENTS Registered trademarks used in this book IX Contributing authors xi Dedication by Jack M. Matloff xvii Preface by Jack M. Matloff xix Keynote address by Denton A. Cooley xxiii I COMPLICATIONS OF CARDIAC VALVE REPLACEMENTS AND THEIR TREATMENT 1. Following the patient with prosthetic heart valves 3 SHAHBUDIN RAHIMTOOLA 2. Thromboembolism after cardiac valve replacement 9 LAWRENCE H. COHN 3. Nonprosthetic factors producing thromboembolism in patients with cardiac valve substitutes: their nature and the problems of assessing their role 17 R. LEIGHTON FISK 4. Anticoagulant therapy and cardiac valvular surgery: Coumadin® and other alternatives 25 SHAHBUDIN RAHIMTOOLA 5. Reoperation after cardiac valve surgery: elective, urgent and emergent 29 JAMES R. PLUTH Discussion 33 LAWRENCE H. COHN, MODERATOR v vi Contents II CARDIAC VALVE SUBSTITUTES: CURRENT STATUS 6. Clinical experience with the caged-ball Starr-Edwards® prosthesis 37 JAMES R. PLUTH 7. Overview of experience with the Bjork-Shiley® valve 41 DONALD B. DOTY 8. Experience with standard and supra-annular Carpentier-Edwards® porcine bioprostheses 45 w. R. ERIC JAMIESON, MICHAEL T. JANUSZ, G. FRANK O. TYERS, ALFRED N. GEREIN, DONALD R. RICCI, LAWRENCE H. BURR, ROBERT T. MIYAGISHIMA 9. Aortic valve replacement with the Ionescu-Shiley® bovine pericardial valve: an 81-month experience 57 LORENZO GONZALEZ-LAVIN, SEONG CHI, T. CALVIN BLAIR, J. Y. JUNG, A. G. FABAZ, BETTY LEWIS, GEORGE DAUGHTERS Discussion 67 DIETER HORSTKOTTE, MODERATOR III CARDIAC VALVE REPLACEMENT IN SPECIAL CIRCUMSTANCES 10. Annuloaortic ectasia: surgical repair using a composite St. Jude Medical® valve and Dacron ® tube graft 73 DENTON A. COOLEY 11. Valve replacement in the geriatric patient using the St. Jude Medical® prosthesis 83 DEMETRE M. NICOLOFF, WILLIAM G. LINDSAY, KIT V. AROM, WILLIAM F. NORTHRUP, III, THOMAS E. KERSTEN 12. Tricuspid valve replacement-a comparative experience with different valve substitutes 91 FRANCIS WELLENS, JEAN-LOUIS LECLERC, F. DEUVAERT, G. VAN NOOTEN, J. GOLDSTEIN, G. PRIMO 13. Double valve replacement 99 RICHARD J. GRAY, LAWRENCE S. C. CZER, AURELIO CHAUX, TIMOTHY M. BATEMAN, MICHELE DEROBERTIS, JACK M. MATLOFF 14. Cardiac valve replacement in the presence of coronary atherosclerosis 111 JACK M. MATLOFF AND LAWRENCE S. C. CZER Discussion 123 DONALD B. DOTY AND EUGENE M. BAUDET, MODERATORS IV CARDIAC VALVE REPLACEMENT IN PEDIATRIC PRACTICE: EXPERIENCE WITH THE ST. JUDE MEDICAL® VALVE 15. St. Jude Medical® valve replacement in infants and children 129 A. MICHAEL BORKON, BRUCE A. REITZ, JAMES S. DONAHOO, TIMOTHY J. GARDNER 16. Pediatric use of the St. Jude Medical® prosthesis 137 ROBERT M. SADE, FRED A. CRAWFORD, JR., HARVEY I. PASS, JOHN M. KRATZ 17. Mitral valve replacement in a child using the St. Jude Medical® valve 141 JOHN W. MACK vii 18. Thromboembolism in children with St. Jude Medical® valves maintained on aspirin and Persantine® 145 STUART L. BOE, KATHLEEN W. MCNICHOLAS, HENRY F. OLIVER, FAUSTINO N. NIGUIDULA, GEORGE J. MAGOVERN, GERALD M. LEMOLE Discussion 155 EUGENE M. BAUDET AND DONALD B. DOTY, MODERATORS V INTERMEDIATE FOLLOW-UP OF PATIENTS WITH ST. JUDE MEDICAL® PROSTHESES: 52 TO 72 MONTHS 19. A 52-month experience with the St. Jude Medical® cardiac prosthesis at the Medical University of South Carolina 163 FRED A. CRAWFORD, JR., JOHN M. KRATZ, ROBERT M. SADE, MARTHA P. STROUD, DAVID M. BARTLES 20. A 57-month experience with the St. Jude Medical® cardiac prosthesis at Hahnemann University Hospital 167 ELDRED D. MUNDTH 21. Incidence of complication with the St. Jude Medical® prosthesis: a 58-month study at Hamot Medical Center 173 GEORGE J. D'ANGELO, G. F. KISH, P. G. SARDESAI, W. S. TAN 22. Mitral valve replacement with St. Jude Medical® prostheses: a 60-month study of 350 cases at Centre Hospitalier Universitaire 179 HENRI DUPON, J. L. MICHAUD, D. DUVEAU, PH. DESPINS, M. TRAIN 23. A 60-month experience with the St. Jude Medical® prosthesis at Cedars-Sinai Medical Center 189 RICHARD J. GRAY, AURELIO CHAUX, LAWRENCE S. C. CZER, MICHELE DEROBERTIS, JACK M. MATLOFF 24. A 60-month experience with the St. Jude Medical® prosthesis at University Hospital, Brugmann 195 JEAN-LOUIS LECLERC, FRANCIS WELLENS, FRANK E. DEUVAERT, MARTINE ANTOINE, JACQUES DEPAEPE, GEORGES PRIMO 25. A 72-month clinical experience with the St. Jude Medical® cardiac valve prosthesis at Newark Beth Israel Medical Center 201 ISAAC GIELCHINSKY, MARK S. HOCHBERG, S. MANSOOR HUSSAIN, VICTOR PARSONNET, DANIEL FISCH, JOHN C. NORMAN 26. A 72-month experience with the St. Jude Medical® cardiac valve prosthesis at the Minneapolis Heart Institute and United Hospitals, St. Paul, Minnesota 205 WILLIAM G. LINDSAY, DEMETRE NICOLOFF, KIT V. AROM, WILLIAM F. NORTHRUP III, THOMAS E. KERSTEN 27. A 72-month clinical experience with the St. Jude Medical® prosthesis at Tucson Medical Center 209 CHRISTOPHER T. MALONEY Discussion 215 SHAHBUDIN RAHIMTOOLA, MODERATOR viii Contents VI CLINICAL EXPERIENCE WITH CURRENT CARDIAC VALVE SUBSTITUTES: COMPARATIVE OBSERVATIONS 28. Late complications in patients with Bjork-Shiley® and St. Jude Medical® prostheses 225 DIETER HORSTKOTTE 29. Experience with the St. Jude Medical® valve and the Ionescu-Shiley® bovine pericardial valve at the Texas Heart Institute 233 J. MICHAEL DUNCAN, DENTON A. COOLEY, GEORGE J. REUL, DAVID A. OTT, JAMES J. LIVESAY, O. H. FRAZIER, WILLIAM E. WALKER, PHILLIP R. ADAMS 30. Comparative assessment of single Bjork-Shiley®, Hancock® and St. Jude Medical® valves at 43 months after operation 247 LESTER R. SAUVAGE, MARY A. O'BRIEN Discussion 261 DEMETRE M. NICOLOFF, MODERATOR VII CLINICAL FORUM 31. Noninvasive assessment of prosthetic heart valve function by continuous-wave doppler ultrasound 269 ANDREAS HOFFMAN, PETER STULZ, ERICH GRADEL, DIETER BURCKHARDT 32. Potential for immobilization of the valve occluder in various valve prostheses 281 OSCAR BAEZA 33. Escape of a leaflet from a St. Jude Medical® prosthesis in the mitral position 285 E. HJELMS, M.D. 34. Prophylaxis against thromboembolism using aspirin and dipyridamole in patients with the St. Jude Medical® aortic prosthesis 291 JOSEPH LOCICERO, III Discussion 293 RICHARD J. GRAY, MODERATOR VIII CLOSING OBSERVATIONS 35. Summary and concluding remarks 301 SHAHBUDIN RAHIMTOOLA 36. Summary and concluding observations 305 JACK M. MATLOFF REGISTERED TRADEMARKS USED IN THIS BOOK BJORK-SHILEY®-Shiley Corporation CARPENTIER-EDWA RDS®-American Edwards Laboratories COUMADIN®-The DuPont Corporation DACRON®-The DuPont Corporation DELRIN®-The DuPont Corporation HANCOCK®-Vascor, Inc. IONESCU-SHILEY® -Shiley Corporation KEFLIN®-Eli Lilly and Company LILLEHEI-KASTER ®-Medical Incorporated MEADOX-COOLEY®-Meadox Medicals, Inc. MEDTRONIC HALLTM-Blood Systems, Inc. OMNISCIENCE®-Medical Incorporated PERSANTINE®-Boehringer Ingelheim SILASTIC®-Dow Coming ST. JUDE MEDICAL®-St. Jude Medical, Inc. STARR-EDWA RDS®-American Edwards Laboratories STELLITE®-Cabot Corporation SWAN-GANZ®-Edwards Laboratories TEFLON®-DuPont Corporation ix CONTRIBUTING AUTHORS Oscar Baeza, M.D. Passaic General Hospital Passaic, NJ 07055 Address for correspondence: 350 Boulevard Passaic, NJ 07055 Eugene M. Baudet Dept. of Cardiovascular Surgery Hopital Cardiologique Av enue de Magellan 33604 Bordeaux France Stuart L. Boe, M.D. Suite 609 3661 South Miami Avenue Miami, FL 33133 A. Michael Borkon, M.D. Division of Cardiac Surgery The Johns Hopkins Hospital 600 North Walfe Street Baltimore, MD 21205 xi xii Contributing authors Lawrence H. Cohn, M.D. Brigham & Women's Hospital 75 Francis Street Boston, MA 02115 Denton A. Cooley, M.D. P.O. Box 20345 Texas Heart Institute of St. Luke's Episcopal and Texas Children's Hospitals Houston, Texas 77225 Fred A. Crawford, Jr., M.D. The Medical University of South Carolina 171 Ashley Avenue Charleston, SC 29425 George J. D'Angelo, M.D. Hamot Medical Center Erie, PA Address for correspondence: 104 East Second Street Erie, P A 16507 Donald B. Doty, M.D. LDS Hospital Primary Children's Medical Center Salt Lake City, UT Address for correspondence: 324 - 10th Av enue Salt Lake City, UT 84103 J. Michael Duncan, M.D. Texas Heart Institute P.O. Box 20345 Houston, TX 77225 Prof. Henri Dupon, M.D. 35, rue Paul Bert 44035 Nantes France