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): Wilbert J. Keon Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Walley, V. M. Articles by Keon, W. J. Search for Related Content PubMed PubMed Citation Articles by Walley, V. M. Articles by Keon, W. J.

Ann Thorac Surg 1992;54:111-116
© 1992 The Society of Thoracic Surgeons

---

Articles

Ionescu-Shiley valve failure I: Experience with 125 standard-profile explants

^a Departments of Pathology and Surgery, University of Ottawa, and University of Ottawa Heart Institute Ottawa, Canada
^b Clinical Epidemiology Unit at the Ottawa Civic Hospital, Ottawa, Canada

Accepted for publication December 18, 1991.

^_* Address reprint requests to Dr Walley, Anatomical Pathology, Ottawa Civic Hospital, 1053 Carling Ave, Ottawa, Ont, K1Y 4E9 Canada.

A group of standard-profile Ionescu-Shiley valve implants, 357 aortic and 190 mitral, was reviewed for cases of failure requiring surgical explantation. To date, 90 (25.2%) of the aortic and 35 (18.4%) of the mitral valves have failed, and are the subject of this analysis. Observations of these explants confirm previous suggestions about the clinical and pathologic patterns of the Ionescu-Shiley valve's failure, but are extended in this study to allow more confident statistical analyses. Cusp tear with insufficiency remains the most important reason for explantation, precipitating removal to date of 19.1% of the aortic and 10.0% of the mitral valves implanted. This difference, aortic versus mitral, is significant (p < 0.006) and the reverse of observations made in other studies of pericardial valves. In this review there is no significant difference in the proportion of aortic and mitral valves that failed with calcification (2.2% and 3.1%, respectively). Aortic Ionescu-Shiley valves failing with tears had a mean of 3.1 tears per valve, whereas mitral valves had 1.2. Aortic valves also showed considerably more pretear wear than did mitral valves. Although the large number of these Ionescu-Shiley valve failures has been a profound clinical disappointment, it has provided an opportunity to observe and detail the pathology of their failure.

This article has been cited by other articles:

				H. Machida, H. Ishibashi-Ueda, K. Nakano, Y. Sasako, J. Kobayashi, K. Bando, K. Minatoya, H. Imamura, and S. Kitamura A morphologic study of Carpentier-Edwards pericardial xenografts in the mitral position exhibiting primary tissue failure in adults in comparison with Ionescu-Shiley pericardial xenografts J. Thorac. Cardiovasc. Surg., October 1, 2001; 122(4): 649 - 655. [Abstract] [Full Text] [PDF]

				V. M. Walley Ionescu-Shiley bioprosthesis cusp "sag" and insufficiency Ann. Thorac. Surg., May 1, 1993; 55(5): 1282 - 1283. [PDF]

				V. M. Walley Ionescu-Shiley valve failures Ann. Thorac. Surg., April 1, 1993; 55(4): 1048 - 1049. [PDF]

				G. L. Grunkemeier Ionescu-Shiley standard-profile and low-profile valves Ann. Thorac. Surg., January 1, 1993; 55(1): 199 - 200. [PDF]

				V. M. Walley, C. A. Keon, M. Khalili, D. Moher, M. Campagna, and W. J. Keon Ionescu-Shiley valve failure II: Experience with 25 low-profile expiants Ann. Thorac. Surg., July 1, 1992; 54(1): 117 - 122. [Abstract] [PDF]