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Farzan Filsoufi
David H. Adams
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Ann Thorac Surg 2004;78:65-66
© 2004 The Society of Thoracic Surgeons

Invited commentary

Farzan Filsoufi, MD, David H. Adams, MD

Department of Cardiothoracic Surgery, Mount Sinai Medical Center 1190 Fifth Ave New York, NY 10029, USA

e-mail: farzan.filsoufi@mountsinai.org
e-mail: david.adams@mountsinai.org

The first 20% of the full text of this article appears below.

Professor Alain Carpentier always tells his audience "a mitral valve replacement is a catastrophe." In virtually every published series, patients undergoing mitral valve replacement have decreased survival compared with those treated by mitral valve repair [1]. The ideal mitral valve substitute remains elusive, and young patients (ie, <65 years old) face the difficult choice between a lifetime of anticoagulation and a 1% to 3% per year bleeding risk if they select a mechanical prosthesis, and a significant risk of reoperation due to long-term structural deterioration if they undergo bioprosthetic valve replacement. Very young patients who are at greater risk for early structural valve degeneration and those patients in developing countries where anticoagulation management is challenging face a particularly daunting choice. Hope that cryopreserved mitral homografts might be a solution have receded due to limited durability and high early . . . [Full Text of this Article]






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Copyright © 2004 by The Society of Thoracic Surgeons.