SATS 2009 Final Program - Scandinavian Association for Thoracic ...

P01:36
ACUTE DYSFUNCTION OF MECHANICAL AORTIC VALVE PROSTHESIS DUE TO PANNUS FORMATION
Ellensen Vegard Skalstad 1 , Andersen Knut S. 1 , Segadal Leidulf 1 , Haaverstad Rune 1
1) Haukeland University Hospital, Bergen, Norway.
Background
Acute dysfunction of mechanical prosthetic aortic valves is a life threatening complication. The common symptoms
are chest pain and dyspnoea, which may be intermittent. Loss of valve click is often noticed by the patient or relatives.
Patient history is of utmost importance for the diagnosis, which is confirmed by echocardiography, cinefluoroscopy or
both. It is important to differentiate between thrombosis and pannus, as the former can be treated by thrombolysis,
while the latter should be operated acutely.
Patients and results
We have reviewed 12 patients (13 episodes) suffering from acute dysfunction of a mechanical aortic valve caused
by pannus formation. All patients were initially operated with a monoleaflet aortic valve prosthesis (Medtronic-Hall)
between 1984 and 1999. Mean age at the primary operation was 48 years (range 22-66 years). 67% were female,
33% male. Mean time from primary surgery to acute dysfunction was 11.5 years (range 4.3-24.7 years). One patient
had redo-surgery twice. All the reoperated patients (67%) survived. Four patients (33%) died in-hospital before
initiation of redo-surgery. The cause of death was confirmed by autopsy.
Conclusion
Acute dysfunction of mechanical aortic valves caused by pannus is a life threatening complication with high mortality.
As soon as the diagnosis is confirmed, redo-surgery should be performed. In our material, the prognosis was good
when the patients were reoperated in time, but bad for those who did not reach the operating theatre.
P01:37
EARLY HEMODYNAMIC PERFORMANCE OF PORCINE AND PERICARDIAL PROSTHESES IN
AORTIC POSITION
Påhlman Carin 1 , Nylander Eva 2 , Franzén Stefan 3 , Tamás Éva 3
1) Faculty of Health Sciences, Linköping, 2) Dept. of Clin. Physiology Linköping,
3) Dept. of Cardiothor. Surg., Linköping, Sweden
Background
The performance of the bioprosthesis after aortic valve replacement (AVR) is of major importance for the long-term
outcome and quality of life. The aim of this retrospective study was to compare the early postoperative hemodynamic
performances of pericardial versus porcine bioprostheses used in our institution.
Methods
The study group included 48 patients operated with isolated AVR in 2008. Hancock II (n=24) implants were compared
to Perimount 2900 (n=24) matched for gender, age, body surface area and prosthesis size (labelled 21 to 27).
Transthoracic echocardiography was performed 3-12 days postoperatively.
Results
The pericardial group had a significant lower max velocity and mean gradient (2.62 ± 0.44 m/s, 15.8 ± 4.2 mmHg
versus 3.08 ± 0.44 m/s, 21.8 ± 6.5 mmHg, p