A Single-Center Experience of the Sorin Bicarbon Heart Valve Prosthesis: Long-Term Clinical, Hematological and Hemodynamic Results
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| Background and aim of the study: The Sorin Bicarbon
(SB) bileaflet valve, available since 1990, has a good clinical safety
profile. The study aim was to assess the long-term clinical results following
implantation, plus hemodynamic and hematological aspects of the valve. Methods: A total of 195 SB prostheses (100 aortic, 67 mitral, 14 double valve replacements) was implanted in 181 patients (108 males, 73 females) since 1991. Results: Mean age at implantation was 60.5 ± 10.8 years. Actuarial analysis at 9.0 years showed an overall survival of 63.9 ± 5.5%; 28.2% of deaths were early (n = 11), and 71.8% late (n = 28). Freedom from thrombosis was 99.4 ± 0.6% (one early event, successfully reoperated on), and from embolic events was 86.3 ± 4.7%. Freedom from endocarditis and hemorrhagic complications were respectively 98.1 ± 1.1% and 98.6 ± 0.9%. No occurrence of hemolysis was reported. Freedom from non-structural valve dysfunction was 98.7 ± 0.9%, and from reoperation was 96.1 ± 1.6%. Hemodynamic evaluation by |
echocardiography and hematological testing was performed
at 7.0 ± 1.3 years (range 5-9 years) in a subset of 31 patients
(20 males, 11 females). Mean valve size was 23.9 mm for aortic prostheses
and 29 mm for mitral. Echocardiography showed that aortic valves had a
mean effective orifice area (EOA) of 2.26 ± 1.28 cm2, with peak
and mean pressure gradients of 23.6 ± 14.6 and 12.9 ± 8.1
mmHg, respectively. The mean EOA of mitral valve prostheses was 2.67 ± 0.66
cm2, with peak and mean pressure gradients of 12.2 ± 4.5 and 3.8 ± 1.6
mmHg, respectively. Overall mean hemoglobin was 13.4 ± 1.35 g/dl,
and serum lactate dehydrogenase 630 ± 13 IU/l. Serum haptoglobin
was detectable in one patient only, and the mean reticulocyte count was
1.24 ± 0.51%. Conclusion: In the present authors' experience, the Sorin Bicarbon prosthesis has low complication rates and maintains an excellent hemodynamic function over time. Hemolytic potential is insignificant with this valve. |
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