Original ArticlesObstruction of Mechanical Mitral Prostheses: Analysis of Pathologic Findings
Section snippets
Material and Methods
From May 1981 to December 1994, 1,878 patients underwent mitral valve replacement using mechanical prostheses at our institutions; of them, 479 (25.5%) received a caged-ball valve, 928 (49.4%) a tilting-disc valve, and 471 (25.1%) a bileaflet valve. During this time 83 (4.42%) of the 1,878 patients suffered prosthetic valve obstruction, 1.9% (9/479) with a caged-ball valve, 6.8% (63/928) with a tilting-disc valve, and 2.3% (11/471) with a bileaflet valve.
The entire study population was made up
Results
Obstruction occurred from 4 days to 14 years (mean, 4.3 ± 3.45 years) after valve replacement.
Comment
The first and most relevant finding in our series was the very high incidence of cases in which the moving element of the prosthesis was gradually blocked until complete arrest occurred as the result of an overgrowth of fibrous tissue that invaded the valve orifice. The presence of pannus, either alone or in association with secondary thrombi, was ascertained in 75.8% (66/87) of the patients. These findings are in contrast with those cited in reports of the major series of patients with
Acknowledgements
We gratefully thank Professor Gilda Caruso for reviewing the manuscript and Dr Domenico Paparella for collecting data.
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