Clinical and hemodynamic study of tilting disc heart valve: Single-center study

Malhotra, Amber; Pawar, Sanjay; Srivastava, Anubhav; Yadav, B. S.; Kaushal, Ramprasad; Sharma, Praveen; Songra, Moolchand

doi:10.1177/0218492313475640

Cited by 4 publications

(8 citation statements)

References 21 publications

(43 reference statements)

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“…As a consequence, rate of atrial fibrillation was high in our study, reflecting the higher proportion of mitral valve disease. 12,14 Early mortality was much lower in our study, compared to previous reports of SJM at mitral and aortic positions (3%-7%). 15 This is attributable to the younger age and stringent exclusion criteria.…”

Section: Resultscontrasting

confidence: 66%

“…Indeed, MVRs outnumber AVRs in India, as RHD affects the mitral valve preferentially. As a consequence, rate of atrial fibrillation was high in our study, reflecting the higher proportion of mitral valve disease 12,14 …”

Section: Discussionmentioning

confidence: 57%

“…The safety and comparable hemodynamics of CHVP have already demonstrated by many studies from India 11,12 . Doppler gradients of CHVP, implanted at mitral and aortic positions, have been compared with other commercially available valves and similar results have been obtained.…”

Section: Discussionmentioning

confidence: 59%

“…The earlier reports are a decade prior and advances in surgical techniques and perioperative care may have contributed to reduced mortality. Early mortality was also low (0.6%–1.5%) in recent studies with CHVP 12 . Western data on long‐term outcomes after SJM implantation showed higher early mortality for both MVR (3.2%–11.2%) and AVR (3.6%–4.8%), likely due to a higher proportion of patients with poor functional class and inclusion of patients undergoing concomitant surgeries 16 …”

Section: Discussionmentioning

confidence: 97%

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Clinical outcomes of bileaflet St. Jude Medical and tilting disc TTK Chitra mechanical heart valve prosthesis: A comparative study

Kaushik

Mani

Ganapathi

et al. 2022

Journal of Cardiac Surgery

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Background: Comparative data on the clinical outcomes of TTK Chitra mechanical heart valve prosthesis (CHVP), an indigenously developed low-cost tilting disc valve and commonly used bileaflet valve, the St. Jude medical (SJM) prosthesis are sparse. Methods: We conducted a retrospective follow-up study of consecutive patients undergoing mitral (MVR) and aortic valve replacement (AVR) with SJM or CHVP mechanical prostheses over a 6-year period at our institution. Results: Seven hundred and thirty-five patients who underwent isolated MVR (n = 510) or AVR (n = 225) were included in the study. Patients with CHVP were younger and belonged to a lower socioeconomic class. The study cohort was followed-up for 2836 patient-years (SJM: 1865.1, CHVP: 971.0). All-cause mortality (p = 0.894), valve-related mortality (p = 0.681), prosthetic valve thrombosis (p = 0.155), embolism (p = 0.210), hemorrhage (p = 0.959) andinfective endocarditis (IE, p = 0.084) were similar between both valve on follow-up. Estimated event free survival was 2302 ± 1 days in SJM as compared to 2484 ± 65 days in CHVP group (p = 0.393). Valve type was not an independent predictor of adverse events after adjusting for baseline data, time in therapeutic range and aspirin use. Subgroup analysis of patients who underwent MVR and AVR showed similar functional improvement and outcomes, except for a higher incidence of IE with SJM at the aortic position (p = 0.041). Conclusion:The indigenously developed, low-cost CHVP has comparable midterm clinical performance as SJM in aortic or mitral positions.

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Section: Resultscontrasting

confidence: 66%

Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 97%

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Clinical outcomes of bileaflet St. Jude Medical and tilting disc TTK Chitra mechanical heart valve prosthesis: A comparative study

Kaushik

Mani

Ganapathi

et al. 2022

Journal of Cardiac Surgery

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“…Monoleaflet mechanical valves are still used in some countries because of the lower cost. 18 However, monoleaflet AVs should not be used in DVR because of the sudden catastrophic events caused by subaortic pannus.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes of Repeat Aortic Valve Replacement for Subaortic Pannus in Mechanical Aortic Valve

Park

Jeong

et al. 2018

Circ J

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Background: This study aimed to evaluate the early and late clinical outcomes after repeat aortic valve replacement (AVR) for subaortic pannus in patients with mechanical valves. Methods and Results:Between 2001 and 2017, 51 patients (median age, 59 years; 42 women) with prosthetic aortic stenosis (AS) caused by pannus ingrowth underwent repeat AVR because of acute malfunction of monoleaflet valve (3 patients), severe prosthetic AS (30 patients), and moderate prosthetic AS at the time of tricuspid or mitral valve surgery (18 patients). The median follow-up duration was 100 (interquartile range, 64-138) months. Double valve replacement was performed in 45 (88%) patients. Median time interval from previous operation was 161 (interquartile range, 121-194) months. The explanted mechanical AV was monoleaflet and bileaflet in 16 (31%) and 34 (67%) patients, respectively. Concomitant procedures included 16 mitral valve replacements (14 repeat) and 36 tricuspid valve surgeries (15 replacements, 21 repairs). No hospital deaths or cases of heart block occurred. Overall survival and event-free survival rates at 10 years were 88% and 51%, respectively. Late complications included recurrent prosthetic AS (4 patients), new paravalvular leakage of the mitral valve (5 patients), and severe tricuspid regurgitation (2 patients). Conclusions:Although repeat AVR for subaortic pannus had acceptable early and late survival, recurrent prosthetic AS was frequently observed during late follow-up.

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Aortic valve replacement in small aortic root- Bi-leaflet mechanical valve is superior to a Mono-leaflet mechanical valve

Rajan

Kaskar

Selvam

et al. 2023

Indian J Thorac Cardiovasc Surg

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Background Patient prosthetic mismatch is a serious but avoidable complication of surgical aortic valve replacement (SAVR) complicated by a small aortic annulus. This study aims to compare early and midterm outcomes following aortic valve replacement (AVR) with a mono-leaflet (ML) valve and a bi-leaflet (BL) valve in a small aortic root. Methods and selection From January 1st, 2017 to December 31st, 2019, 98 patients diagnosed with small aortic root underwent isolated aortic valve replacement with either TTK Chitra valve (Mono-leaflet/ ML group) or St. Jude medical valve (Bi-leaflet/ BL group) of size 17/ 19 mm. Echocardiography was analyzed from medical records and telephonic follow-up. Results Baseline parameters were comparable. The ML group had 42 patients and the BL group had 56 patients. Aortic cross-clamp time, the incidence of severe patient prosthetic mismatch ( p = 0.002) and mean, peak pressure gradients were high in the ML group. Duration of ventilation, intensive care unit (ICU) stay, the incidence of stroke, need for intra-aortic balloon pump, permanent pacemaker, dialysis, and left ventricular mass index in echocardiography were comparable between the two groups postoperatively. There was no early mortality in both group. Survival at the end of 5 years was 57 ± 14.4% in the ML group; 91.8 ± 4% in the BL group ( p = 0.005). Univariate and multivariate analysis revealed elderly age as a risk factor for mortality. Conclusion We conclude that aortic valve replacement without any root widening procedure, using a small-sized mechanical valve provides acceptable early outcomes. Bi-leaflet mechanical valves provide better hemodynamics and survival percentage.

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Clinical and hemodynamic study of tilting disc heart valve: Single-center study

Abstract: The performance of this valve in terms of hemodynamic complications, mortality, and morbidity is comparable to other valves in common use. Hemodynamic gradients are more reproducible than effective orifice area, hence more beneficial for follow-up.

Cited by 4 publications

References 21 publications

Clinical outcomes of bileaflet St. Jude Medical and tilting disc TTK Chitra mechanical heart valve prosthesis: A comparative study

Clinical outcomes of bileaflet St. Jude Medical and tilting disc TTK Chitra mechanical heart valve prosthesis: A comparative study

Clinical Outcomes of Repeat Aortic Valve Replacement for Subaortic Pannus in Mechanical Aortic Valve

Aortic valve replacement in small aortic root- Bi-leaflet mechanical valve is superior to a Mono-leaflet mechanical valve

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