Indications for Heart Valve Replacement by Age Group

The papers presented at the Fifth International Symposium on Heart Valves and published in this volume discuss clinical experience with heart valve replacement in pediatric patients, in adults (age 65 and younger), and in the elderly (age 66 and older). Special considerations in heart valve replacement, such as valve selection, reoperation, results of double valve implantation, quality of life, and the use of valved conduits are also included. Finally, long term clinical follow-up with the ST. JUDE MEDICAL® heart valve, giving 7- and 8-year data is discussed. HEART VALVE REPLACEMENT IN PEDIATRIC PATIENTS Anticoagulation Anticoagulation in children is a difficult and interesting problem. Three princi pal considerations in the use of anticoagulants are patient education, timing, and anticoagulating substance. Additional considerations are patient tolerance and compliance. Generally, the findings indicate, if pediatric patients receive anticoagulation following mechanical valve replacement, it is well accepted and results in few complications. If children are not anticoagulated, complications arise. Conflicting results regarding the efficacy of PERSANTINE® and the use of aspirin vs. COUMADIN® were reported. Doctor Sade's data address some of these questions. After a 5-year study in See J Thorac Cardiovasc Surgery 1988; 95:533-561.

Klappentext

Proceedings of the Fifth International Symposium on Heart Valves, Ft. Lauderdale, Florida, April 1-4, 1987

Inhalt
I. Experience with Heart Valve Replacement in Pediatric Patients.- 1. The durability of the St. Jude Medical® valve in children.- 2. A seven-year experience with the St. Jude Medical® heart valve.- 3. St. Jude Medical® cardiac valve experience in infants and children.- 4. Thromboembolic complications in pediatric patients undergoing valve replacement with the St. Jude Medical® prosthesis.- 5. Long-term results of valvular replacement in pediatric patients.- 6. Performance of mechanical valves in pediatric patients.- I. Discussion.- II. Heart Valve Replacement in Adults (Age 65 and Younger).- 7. Prospective randomized study of the St. Jude Medical®, Björk-Shiley®, and Starr-Edwards® 6120 valve prostheses in the mitral position.- 8. Nine years experience with 1287 Carpentier-Edwards® porcine bioprostheses.- 9. Primary tissue failure in porcine aortic and bovine pericardial bioprostheses.- 10. Midterm follow-up of the BioImplant™ (Liotta) heart valve.- 11. A comparison of St. Jude Medical® and Carpentier-Edwards® xenograft valves in the mitral position.- 12. Three-dimensional visualization of velocity fields downstream of the St. Jude Medical® aortic valve implanted in pigs.- 13. Quality of life after valve replacement with the St. Jude Medical BioImplant™ heart valve: a four-year study.- 14. Cinefluoroscopic follow up of the St. Jude Medical® valve in the aortic position.- 15. Thromboembolism in adults with St. Jude Medical® valves on ticlopidine and aspirin maintenance.- 16. Midterm follow-up of the St. Jude Medical® heart valve.- II. Discussion.- III. Valve Replacement in the Elderly (Age 66 and Older).- 17. Combined valve and coronary artery bypass procedures in septuagenarians and octogenarians: results in 119 patients.- 18. The Ionescu-Shiley®xenobioprosthesis as an aortic valve substitute in patients 66 years of age and older.- 19. Valve replacement in the elderly: operative risk and early postoperative results.- 20. Aortic valve replacement in patients 75 years and over.- 21. Durabilty and long-term results of aortic valve replacement in the elderly.- III. Discussion.- IV. Considerations in Heart Valve Replacement.- 22. Mechanical or tissue valves: Factors influencing differential therapy.- 23. Comparative analysis of mechanical and bioprosthetic valves following aortic valve replacement.- 24. Technical problems in aortic valve re-replacement.- 25. Hydrodynamics of cardiac valve prostheses: Is excellence necessary?.- 26. Surgical treatment of prosthetic valve endocarditis.- 27. Performance of four different types of mechanical and two bioprosthetic valves in the tricuspid position.- 28. Comparison of reoperation and complications in double valve (mitral and aortic) implants with mechanical or biological prostheses.- 29. Quality of life in patients with mechanical heart valves: Influence of anticoagulation therapy and valve noise.- 30. Valved conduits and conduit exchange: long-term follow-up.- IV. Discussion.- V. Long-Term Clinical Follow-Up.- 31. Seven-year experience and follow-up with St. Jude Medical® prostheses.- 32. Durability and low thrombogenicity of the St. Jude Medical® heart valve: long-term follow-up.- 33. Aortic and mitral valve replacement with the St. Jude Medical® prosthesis: a nine-year update report.- 34. Eight-year clinical experience with the St. Jude Medical® cardiac prosthetic valve.- 35. Heart valve replacement with the St. Jude Medical® valve prosthesis: long-term experience in 743 patients receiving valve implants in Switzerland.- V. Discussion.