Autologous fascia lata for heart valve replacement

Ionescu, Marian I.; Ross, Donald N.; Deac, Radu C.; Grimshaw, V. A.; Taylor, Stanley H.; Whitaker, William; Wooler, Geoggrey H.

doi:10.1136/thx.25.1.46

Cited by 49 publications

(8 citation statements)

References 31 publications

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“…Aortic valve replacement with either a homograft (Ross, 1968) or a fascia lata valve (Ionescu et al, 1970) had been carried out. The condition of the patients was clinically stable; they were in sinus rhythm and the investigation was done within 24 hours of operation.…”

Section: Methodsmentioning

confidence: 99%

Atrial and ventricular pacing after open heart surgery

Wisheart

Wright

Rosenfeldt

et al. 1973

Thorax

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The effect of cardiac pacing, through a wide range of pacing rates, has been studied in 13 patients in stable sinus rhythm within 24 hours of operation. Using first atrial and then ventricular pacing, the cardiac rate was raised to 60% above control value. The effects of atrial and ventricular pacing were compared by observing the differences in the various parameters measured at corresponding paced heart rates. With atrial pacing there was no significant difference in the cardiac output, mean aortic pressure, mean left atrial pressure, or left ventricular work. During ventricular pacing there were significant falls in cardiac output (P<0-05), mean aortic pressure (P<0-01), and left ventricular work (P

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Section: Methodsmentioning

confidence: 99%

Atrial and ventricular pacing after open heart surgery

Wisheart

Wright

Rosenfeldt

et al. 1973

Thorax

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“…At the beginning of the series (cases A1 to A60), the dimensions for the fascia lata graft recommended by Ionescu (1970) were used. It was found more satisfactory, however, to increase the length of the fascia1 strip up to 11 mm (cases A61 to A71).…”

Section: Technical Considerationsmentioning

confidence: 99%

Aortic Valve Replacement with Frame-Supported Autologous Fascia Lata Grafts:I. Technical Considerations and Early Results

Dubiel

Hallén

Johansson

1975

Scandinavian Journal of Thoracic and Cardiovascular Surgery

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During the period November 1969 to June 1972, a frame-supported autologous fascia lata graft was implanted in 71 consecutive patients with surgically treated aortic valve disease at the Department of Thoracic & Cardiovascular Surgery, University Hospital, Uppsala. The follow-up period was between 1 and 4 years. Eleven patients died within 28 days of the operation (16%) and 13 after discharge from hospital (18%); the cumulative mortality was thus 34%. Forty-five percent of the patients who died had associated cardiovascular or other diseases. The causes of death were infection (10), myocardial failure (6), myocardial infarction (3), cerebral damage (3), and intraoperative aortic dissection from the cannulation site (2). The majority of the deaths (88%) occurred within 6 months and all within 13 1/2 months after operation. Two fascia lata valves were removed because of endocarditis 23 and 26 months, respectively, after operation. Two valves were also removed on account of mechanical malfunction. The remaining 44 patients with fascia lata valves had returned to work. No embolic complications occurred, despite the fact that only patients with a concomitant prosthetic mitral valve or atrial fibrillation received anticoagulatant treatment. Haemodynamic studies of the valve in vitro and pressure measurements during the operation showed that the valve had a low primary systolic peak gradient of 0-16 mmHg. Certain modifications in the construction aimed at improving the haemodynamic properties of the valve are discussed. Increased stringency in the sterility precautions during the valve construction procedure may have contributed to the fact that early endocarditis, which is a serious complication, did not occur in any of the last 43 patients. As yet the observation time is too short to judge, however, to what extent susceptibility to infection and possible late changes of the valve can affect its function.

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“…Fascia lata mounted on a prosthetic support has the advantage that the valve is constructed before the aorta is opened. However, the prosthetic support used (Ionescu et al, 1970;Edwards et al, 1969) represents in itself a rigid obstacle to ventricular ejection. A ventriculo-aortic gradient is thus created.…”

Section: Clinical Applicationmentioning

confidence: 99%

“…The latter is nearing normal anatomical and physiological conditions. The successful use of such a valve in a case of acute bacterial endocarditis is described.Based on Senning's (1967) technique of aortic valve reconstruction with fascia lata, and on our own experience with Edwards' (Edwards, Karp, Robillard, and Kerr, 1969) and Ionescu's methods of fashioning fascia lata valves (Ionescu, Ross, Deac, Grimshaw, Taylor, Whitaker, and Wooler, 1970) we have developed a new procedure for the construction of aortic fascia lata valves without prosthetic support. …”

mentioning

confidence: 99%