HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): William W. Angell Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Angell, W. W. Articles by Sywak, A. Search for Related Content PubMed PubMed Citation Articles by Angell, W. W. Articles by Sywak, A.

Ann Thorac Surg 1979;28:537-553
© 1979 The Society of Thoracic Surgeons

---

Articles

The Angell-Shiley Porcine Xenograft

From Western Heart Associates, and the Western Heart Institute and the Institute for Medical Research, San Jose, CA.

^* Address reprint requests to Dr. W. Angell, 2101 Forest Ave, Suite 222, San Jose, CA 95128.

A 4-year clinical experience with fresh allograft tissue valves prompted a trial of 0.5% buffered glutaraldehyde as a valve fixative and sterilant. Tanned allograft and porcine xenograft valves were inserted into experimental animals, and, beginning in 1970, similar valves were implanted in a series of patients now totaling 312. The clinical results are excellent. The 5-year valve-related mortality is 6% for patients who had mitral valve replacement and 16% for those with aortic valve replacement. To date, the incidence of thromboembolism is 1.3% per patient-year, and valve-related morbidity and mortality for the combined groups is 27.4%.

Valve stent design has evolved from symmetrically configured metal to anatomically molded plastic. The maintenance of natural valve configuration has optimized leaflet coaptation and support, decreased tissue stress, and eliminated valve-stent dehiscence and tissue rupture seen in valves deformed to fit symmetrical stents. Stent design, controlled glutaraldehyde solutions, and fixation techniques have improved leaflet flexibility and reduced valve orifice to annulus diameter ratios, thus producing transvalvular gradients comparable to both mechanical and modified orifice tissue valves. To date, tissue failure, observed in only 1.0% (3 of 287) of patients, is the result of calcification (2 patients) and cusp rupture due to incomplete fixation (1 patient).

This article has been cited by other articles:

				M. J. Antunes, M. Med., and L. P. Santos Performance of Glutaraldehyde-Preserved Porcine Bioprosthesis as a Mitral Valve Substitute in a Young Population Group Ann. Thorac. Surg., May 1, 1984; 37(5): 387 - 392. [Abstract] [PDF]

				L. Nunez, M. G. Aguado, J. L. Larrea, D. Celemin, and J. Oliver Prevention of Thromboembolism Using Aspirin after Mitral Valve Replacement with Porcine Bioprosthesis Ann. Thorac. Surg., January 1, 1984; 37(1): 84 - 87. [Abstract] [PDF]

				C. Pelletier, B. R. Chaitman, R. Baillot, P. G. Val, R. Bonan, and I. Dyrda Clinical and Hemodynamic Results with the Carpentier-Edwards Porcine Bioprosthesis Ann. Thorac. Surg., December 1, 1982; 34(6): 612 - 624. [Abstract] [PDF]

				L. Nunez, M. G. Aguado, D. Celemin, A. Iglesias, and J. L. Larrea Aspirin or Coumadin as the Drug of Choice for Valve Replacement with Porcine Bioprosthesis Ann. Thorac. Surg., April 1, 1982; 33(4): 354 - 358. [Abstract] [PDF]

				R. M. Becker, L. Sandor, M. Tindel, and R. W. M. Frater Medium-Term Follow-up of the Ionescu-Shiley Heterograft Valve Ann. Thorac. Surg., August 1, 1981; 32(2): 120 - 126. [Abstract] [PDF]

				R. Rivera, C. Infantes, J. L. Delcan, and M. Rico Clinical and Hemodynamic Assessment of the Angell-Shiley Porcine Xenograft Ann. Thorac. Surg., November 1, 1980; 30(5): 455 - 464. [Abstract] [PDF]

				J. B. Williams, R. B. Karp, J. W. Kirklin, N. T. Kouchoukos, A. D. Pacifico, G. L. Zorn Jr., E. H. Blackstone, R. N. Brown, S. Piantadosi, and E. L. Bradley Considerations in Selection and Management of Patients Undergoing Valve Replacement with Glutaraldehyde-Fixed Porcine Bioprostheses Ann. Thorac. Surg., September 1, 1980; 30(3): 247 - 258. [Abstract] [PDF]