ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Hartzell V. Schaff
Thierry P. Carrel
Kent W. Jones
Denton A. Cooley
Roland Hetzer
Daniel Duveau
Patterson Moseley
Gary L. Grunkemeier
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Schaff, H. V.
Right arrow Articles by Holubkov, R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Schaff, H. V.
Right arrow Articles by Holubkov, R.
Related Collections
Right arrow Valve disease

Ann Thorac Surg 2002;73:785-792
© 2002 The Society of Thoracic Surgeons

Original article: cardiovascular

Paravalvular leak and other events in silzone-coated mechanical heart valves: a report from AVERT

Hartzell V. Schaff, MD*a,b, Thierry P. Carrel, MDa,b, W.R. Eric Jamieson, MDa,b, Kent W. Jones, MDa,b, Juán José Rufilanchas, MDa,b, Denton A. Cooley, MDa,b, Roland Hetzer, MDa,b, Frank Stumpe, MDa,b, Daniel Duveau, MDa,b, Patterson Moseley, MDa,b, Wim Jan van Boven, MDa,b, Gary L. Grunkemeier, PhDa,b, Elizabeth D. Kennard, PhDa,b, Richard Holubkov, PhDa,b

a Division of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA
b the AVERT Coordinating Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

* Address reprint requests to Dr Schaff, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
e-mail: schaff{at}mayo.edu

Presented at the Thirty-seventh Annual Meeting of The Society of Thoracic Surgeons, New Orleans, LA, Jan 29–31, 2001.

Background. The Artificial Valve Endocarditis Reduction Trial (AVERT) was designed to compare endocarditis rates in Silzone versus conventional valves. Recruitment ended January 21, 2000, because of higher rates of paravalvular leakage in patients receiving the Silzone prosthesis. The present analysis determined late event rates that might be used in the management of approximately 36,000 patients who have received the Silzone prosthesis.

Methods. A total of 807 patients in 19 centers in North America and Europe were randomized. Mean age was 61 ± 11 years; 41% were women. Operations included aortic valve replacement in 59%, mitral valve replacement in 32%, and aortic and mitral valve replacements in 9%; 41% had concomitant operations (26% coronary artery bypass grafting).

Results. Major paravalvular leakage (followed by repair, explant, or mortality) occurred in 18 of 403 patients receiving Silzone valves and 4 of 404 patients without Silzone valves (2-year event-free rates: 91.1% versus 98.9% conventional, p < 0.003). Similarly, 2-year freedom from any explant was lower in the Silzone arm (19 versus 2 events; 90.1% versus 99.4%, p = 0.0002). Rates of mortality and stroke were similar during follow-up.

Conclusions. Continued follow-up of AVERT supports the conclusion that the Silzone prosthesis has increased risk of paravalvular leakage requiring reoperation. Overall survival is similar in the two groups.




This article has been cited by other articles:


Home page
 Eur J EchocardiogrHome page
A. M. Johri, K. Yared, R. Durst, R. J. Cubeddu, I. F. Palacios, M. H. Picard, and J. Passeri
Three-dimensional echocardiography-guided repair of severe paravalvular regurgitation in a bioprosthetic and mechanical mitral valve
Eur J Echocardiogr, June 1, 2009; 10(4): 572 - 575.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
W.R. E. Jamieson, G. J. Fradet, J. G. Abel, M. T. Janusz, S. V. Lichtenstein, J. S. MacNab, E. A. Stanford, and F. Chan
Seven-year results with the St Jude Medical Silzone mechanical prosthesis.
J. Thorac. Cardiovasc. Surg., May 1, 2009; 137(5): 1109 - 15.e2.
[Abstract] [Full Text] [PDF]

Home page
 Card Surg AdultHome page
R. W. Emery, A. M. Emery, A. Knutsen, and G. V. Raikar
Aortic Valve Replacement with a Mechanical Cardiac Valve Prosthesis
Card. Surg. Adult, January 1, 2008; 3(2008): 841 - 856.
[Full Text]

Home page
 Card Surg AdultHome page
J. P. Greelish, R. M. Ahmad, J. M. Balaguer, M. R. Petracek, and J. G. Byrne
Reoperative Valve Surgery
Card. Surg. Adult, January 1, 2008; 3(2008): 1159 - 1174.
[Full Text]

Home page
 Ann. Thorac. Surg.Home page
G. L. Grunkemeier, R. Jin, and A. Starr
Prosthetic heart valves: objective performance criteria versus randomized clinical trial.
Ann. Thorac. Surg., September 1, 2006; 82(3): 776 - 780.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
G. L. Grunkemeier, R. Jin, K. Im, R. Holubkov, E. D. Kennard, and H. V. Schaff
Time-related risk of the St. Jude Silzone heart valve.
Eur. J. Cardiothorac. Surg., July 1, 2006; 30(1): 20 - 27.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
L. Englberger, H. V. Schaff, W.R. E. Jamieson, E. D. Kennard, K. A. Im, R. Holubkov, T. P. Carrel, and for the AVERT Investigators
Importance of implant technique on risk of major paravalvular leak (PVL) after St. Jude mechanical heart valve replacement: a report from the Artificial Valve Endocarditis Reduction Trial (AVERT)
Eur. J. Cardiothorac. Surg., December 1, 2005; 28(6): 838 - 843.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
M. J. Antunes
Editorial comment: How much can we do to reach the ideal valve prosthesis?
Eur. J. Cardiothorac. Surg., December 1, 2005; 28(6): 843 - 844.
[Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
B. Mahesh, G. Angelini, M. Caputo, X. Y. Jin, and A. Bryan
Prosthetic Valve Endocarditis
Ann. Thorac. Surg., September 1, 2005; 80(3): 1151 - 1158.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
V. G. Davila-Roman, A. D. Waggoner, E. D. Kennard, R. Holubkov, W. R. E. Jamieson, L. Englberger, T. P. Carrel, and H. V. Schaff
Prevalence and severity of paravalvular regurgitation in the Artificial Valve Endocarditis Reduction Trial (AVERT) echocardiography study
J. Am. Coll. Cardiol., October 6, 2004; 44(7): 1467 - 1472.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
G. L. Grunkemeier and Y. Wu
The Silzone effect: how to reconcile contradictory reports?
Eur. J. Cardiothorac. Surg., March 1, 2004; 25(3): 371 - 375.
[Abstract] [Full Text] [PDF]

Home page
 HeartHome page
A Ionescu, N Payne, A G Fraser, J Giddings, G L Grunkemeier, and E G Butchart
Incidence of embolism and paravalvar leak after St Jude Silzone valve implantation: experience from the Cardiff Embolic Risk Factor Study
Heart, September 1, 2003; 89(9): 1055 - 1061.
[Abstract] [Full Text] [PDF]

Home page
 Card Surg AdultHome page
F. J. Schoen and R. F. Padera Jr.
Cardiac Surgical Pathology
Card. Surg. Adult, January 1, 2003; 2(2003): 119 - 185.
[Full Text]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2002 by The Society of Thoracic Surgeons.