In Vivo Evaluation of the Lillehei-Kaster Heart Valve Prosthesis

Sigwart, Ulrich; Schmidt, Harald; Gleichmann, U; Borst, H. G.

doi:10.1016/s0003-4975(10)64905-3

Cited by 35 publications

(8 citation statements)

References 7 publications

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“…In both groups of patients small diastolic pressure gradients across the mitral valve were found at rest approximately of the same order as in series with single mitral disc valve prosthesis (3,12,14,15,24). In the aortic position the B-S valve proved to be the better one since zero peak to peak systolic gradient could be found in nearly all patients.…”

Section: Discussionsupporting

confidence: 57%

“…The complete absence of transvalvular gradient differed somewhat from the results of single aortic valve replacement with this prosthesis (8,11). Most patients with L-K valves had a measurable gradient across the aortic valve, but the gradients were in general lower than in series with single L-K aortic valve prostheses (11,12,14,24). The finding of lower gradients with double valve than with single position has also been reported following bivalvular replacement with StarrEdwards prosthesis (2).…”

Section: Discussionmentioning

confidence: 88%

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Combined Aortic and Mitral Valve Replacement. A Randomized Study Comparing the Björk-Shiley and Lillehei-Kaster Disc Valve

Rostad

Simonsen

Nitter-Hauge

1979

Thorac cardiovasc Surg

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The present series was comprised of 48 patients, 25 of whom received the Björk-Shiley (B-S) and 23 the Lillehei-Kaster (L-K) disc valves. The 2 groups were comparable with regard to age, and to preoperative clinical and hemodynamic status. The randomized selection was carried out at the beginning of the operation. The total mortality in the B-S and L-K groups was 16% and 21% respectively. All surviving patients were restudied 13-40 months (mean 27) after surgery. Late thromboembolic complications occurred in 2 patients with B-S and in 3 with L-K valves, all leaving minor neurological sequelae. There was a relatively large number of patients in the L-K group with unmeasurable values of haptoglobin, indicating more hemolysis in these patients. However, the difference was not statistically significant. The clinical and hemodynamic status was improved in both groups. In the aortic position a significant gradient was found across the L-K valve, while no significant obstruction in the flow was found in the B-S valve. The pulmonary arteriolar resistance was significantly higher in patients with B-S than in those with L-K valves. Otherwise, there was no significant differences between the 2 groups, neither with regard to clinical nor to hemodynamic status.

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Section: Discussionsupporting

confidence: 57%

Section: Discussionmentioning

confidence: 88%

Combined Aortic and Mitral Valve Replacement. A Randomized Study Comparing the Björk-Shiley and Lillehei-Kaster Disc Valve

Rostad

Simonsen

Nitter-Hauge

1979

Thorac cardiovasc Surg

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“…Our data on the Lillehei-Kaster prostheses reflect our initial indiscriminate use of the smaller sized valves (33,64). The higher pressure gradient in the smaller Lillehei-Kaster prostheses, when compared to Björk-Shiley prostheses at equal tissue annulus size, is due to the former's heavier suturing ring, and this disadvantage is not compensated for by the supposedly greater opening angle of the disc (3,49,50).…”

mentioning

confidence: 52%

“…We continued to employ the Starr-Edwards valve, however, until 1975 in view of modifications in design which were thought to eliminate cloth wear, whenever a rigid aortic annu- Thoracic andCardiovascular Surgery, Hannover, 1968-1978 lus invited the use of a prosthesis with a well cushioned suturing ring. Our enthusiasm for the Lillehei-Kaster valve waned from 1974 onwards as our postoperative investigations revealed undesirable hemodynamic behaviour in this prosthesis, particularly in small aortic fundaments (33,64). During the years that followed, we preferred the Björk-Shiley valve* for these cases.…”

mentioning

confidence: 99%

“…A number of investigators (10,31,36,37,39,41) as well as ourselves (33,64) have measured aortic valve gradients at rest and during exercise as shown in Table 1. From this clinical material, comprising a variety of valve sizes, it appears that the LilleheiKaster prostheses and the Hancock porcine xenograft produce higher exercise gradients than either the Starr-Edwards or the Björk-Shiley variety.…”

mentioning

confidence: 99%

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Cardiac Valve Replacement. Problems Solved and Unsolved

Hg¹,

Papagiannakis²,

Bedderman³

et al. 1979

Thorac cardiovasc Surg

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In this review the present state of cardiac valve replacement is summarized on the basis of the literature and personal experience in approximately 1500 cases, using various prosthetic models. Durability, hemodynamic performance at rest and during exercise, and thromboembolic risk are considered in particular and our choice of the various valve models is discussed on these grounds. The long-term durability has been significantly improved and has possibly been solved in the more advanced mechanical valves, while this question is still open in the present biological prostheses. Hemodynamic performance is considered less than optimal in all conventional mechanical prostheses and in the xenografts. Pressure gradients are abnormal in all mechanical as well as in stented biological prostheses, the latter being less likely to solve the problem of a narrow aortic root. The significantly lower incidence of thromboembolism and total valve thrombosis and the absence of anticoagulation accidents in patients with bioprostheses has tipped the balance for the present in favor of the latter, particularly in mitral valve replacement and certainly in all those patients in whom anticoagulation in impossible, unlikely, or undesirable.

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Key references in biomaterials: Heart valve replacement

Schoen

Braunwald

1983

J. Biomed. Mater. Res.

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Editorial Note: With this issue we introduce a new feature of the Journal of Biomedical Materials Research entitled, "Key References in Biomaterials." Our purpose is to provide carefully selected references on timely and important subjects to permit the reader to explore the topic in depth. The editors recognize the increasingly difficult task of information exchange in science and technology, in general, and in biomaterials, with its interdisciplinary biologicall physical interfaces, in particular. I have askedDr. Frederick 7. Schoen to coordinate this section. He will invite various individuals to compile references on subjects in which they have special expertise. Often, the nature of the subject matter will require that these lists be assembled by several collaborating individuals, each of a different discipline. Space limitations necessitate selectivity, so that no inference should be drawn if an article is not cited. The objective is a unique, organized, and readily usable scheme for each topic which represents the historical and conceptual development of a subject as well as the state-of-the-art. W e hope that you will find these key references useful, and we welcome suggestions. 1. 2. 3. 4. 5. 6. 7. I. DISEASES OF THE NATURAL HEART VALVES: PATHOPHYSIOLOGICAL AND CLINICAL ASPECTSBraunwald, E. Mitral Regurgitation. Physiologic, Clinical and Surgical Considerations, N. Engl.

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In Vivo Evaluation of the Lillehei-Kaster Heart Valve Prosthesis

Cited by 35 publications

References 7 publications

Combined Aortic and Mitral Valve Replacement. A Randomized Study Comparing the Björk-Shiley and Lillehei-Kaster Disc Valve

Combined Aortic and Mitral Valve Replacement. A Randomized Study Comparing the Björk-Shiley and Lillehei-Kaster Disc Valve

Cardiac Valve Replacement. Problems Solved and Unsolved

Key references in biomaterials: Heart valve replacement

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