Ann Thorac Surg 1975;19:487-493
© 1975 The Society of Thoracic Surgeons
Articles
Fifty-two Consecutive Aortic Valve Replacements Employing Local Deep Hypothermia
Dennis F. Pupello, M.D.*,
Richard H. Blank, M.D.,
Richard G. Connar, M.D.,
Luis N. Bessone, M.D.,
Sheldon Sbar, M.D.,
Arthur Stevenson, M.D.
Cardiology Center and Cardiac Surgical Unit, Tampa General Hospital, Tampa, Fla
* Address reprint requests to Dr. Pupello, Cardiac Surgical Unit, Tampa General Hospital, Tampa, Fla. 33606
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Abstract
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From August, 1972, to May, 1974, 52 consecutive aortic valves were replaced with the Björk-Shiley tilting-disc prosthesis. The hospital mortality was zero. Patients ranged in age from 14 to 77 years, and 19 patients had simultaneous correction of associated cardiac lesions. Using techniques of low flow and local deep hypothermia, aortic valve replacement can be accomplished with little risk even in patients with associated coronary arteriosclerosis. Coronary artery perfusion is unnecessary and often hazardous. Follow-up periods vary from one to twenty-one months. Forty-nine patients are alive and substantially improved.
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Footnotes
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Presented at the Twenty-first Annual Meeting of the Southern Thoracic Surgical Association, Williamsburg, Va., Nov. 7–9, 1974.
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References
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- Angell WW, Rikkers L, Dong Jr. E, Shumway NE. Organ viability with hypothermia J Thorac Cardiovasc Surg 1969;58:619.[Medline]
- Björk VO. A new tilting disc valve prosthesis Scand J Thorac Cardiovasc Surg 1969;3:1.[Medline]
- Björk VO. The pyrolite carbon occluder for the Björk-Shiley tilting disc valve prosthesis Scand J Thorac Cardiovasc Surg 1972;6:109.[Medline]
- Björk VO, Henze A, Holmgren A. Central haemodynamics at rest and during exercise before and after aortic valve replacement with the Björk-Shiley tilting disc valve in patients with isolated aortic stenosis Scand J Thorac Cardiovasc Surg 1973;7:111.[Medline]
- Bokros JC, Gott VL, LaGrange LD, Fadali AM, Ramos, MD. Heparin sorptivity and blood compatibility of carbon surfaces J Biomed Mater Res 1970;4:145.[Medline]
- Bokros JC, Gott VL, LaGrange LD, Fadali AM, Vos KD, Ramos, MD. Correlations between blood compatibility and heparin adsorptivity for an impermeable isotropic pyrolytic carbon J Biomed Mater Res 1969;3:497.[Medline]
- Cohn LH, Collins Jr. JJ. Local cardiac hypothermia for myocardial protection Ann Thorac Surg 1974;17:135.[Abstract/Free Full Text]
- Fernandez J, Maranhao V, Gooch AS, Morse D, Nichols HT. The Björk-Shiley prosthesis: A significant advance in aortic valve replacement Ann Thorac Surg 1972;14:527.[Abstract/Free Full Text]
- Griepp RB, Stinson EB, Shumway NE. Profound local hypothermia for myocardial protection during open-heart surgery J Thorac Cardiovasc Surg 1973;66:731.[Medline]
- Hurley EJ, Lower RR, Dong Jr. E, Pillsbury RC, Shumway NE. Clinical experience with local hypothermia in elective cardiac arrest J Thorac Cardiovasc Surg 1964;47:50.[Medline]
- LaGrange LD, Gott VL, Bokros JC, Ramos, MD. The Compatibility of Carbon with BloodIn: Hegyeli RJ, editor. Proceedings of the Artificial Heart Conference, Washington, D.C., June 9–13, 1969. Washington, D.C.: U.S. Government Printing Office; 1970. pp. 47.
- Lower RR, Stafer KC, Hurley RC, Dong Jr. E, Cohn RB, Shumway NE. Successful homotransplantation of the canine heart after anoxic preservation for seven hours Am J Surg 1962;104:302.[Medline]
- MacGregor DC, Wilson GJ, Holness DE, Lixfeld W, Yasui H, Tanaka S, Silver, MD, Gunstensen J. Intramyocardial carbon dioxide tension J Thorac Cardiovasc Surg 1974;68:101.[Medline]
- Messmer BJ, Hallman GL, Liotta D, Martin C, Cooley DA. Aortic valve replacement: New techniques, hydrodynamics, and clinical results Surgery 1970;68:1026.[Medline]
- Messmer BJ, Okies JE, Hallman GL, Cooley DA. Aortic valve replacement: Two years' experience with the Björk-Shiley tilting disc prosthesis Surgery 1972;5:772.
- Nakhjavan FK, Maranhao V, Goldberg H. Iatrogenic stenosis of the proximal portion of the coronary arteries: Report of three cases treated with aortocoronary anastomosis Am Heart J 1972;83:318.[Medline]
- Ramsey HW, de la Torre A, Linhart JW, Wheat Jr. MW. Complications of coronary artery perfusion J Thorac Cardiovasc Surg 1967;54:714.[Medline]
- Robicsek F, Tam W, Daugherty HK, Mullen DC. Myocardial protection during open-heart surgery: Coronary perfusion versus topical cardiac hypothermia Ann Thorac Surg 1970;10:340.[Free Full Text]
- Sapsford RN, Blackstone EH, Kirklin JW, Karp RB, Kouchoukos NT, Pacifico AD, Roe CR, Bradley EL. Coronary perfusion versus cold ischemic arrest during aortic valve surgery: A randomized study Circulation 1974;49:1190.[Abstract/Free Full Text]
- Shumway NE, Lower RR. Topical cardiac hypothermia for extended periods of anoxic arrest Surg Forum 1959;10:563.
- Stemmer EA, McCart P, Stanton Jr. WW, Thibault W, Dearden LS, Connolly JE. Functional and structural alterations in the myocardium during aortic cross-clamping J Thorac Cardiovasc Surg 1973;66:754.[Medline]
- Urschel Jr. HC, Greenberg JJ. Differential cardiac hypothermia for elective cardioplegia Ann Surg 1960;152:845.[Medline]
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