Are the indications for tissue valves different in 2001 and how do we communicate these changes to our cardiology colleagues?

Citation
Ji. Fann et Ta. Burdon, Are the indications for tissue valves different in 2001 and how do we communicate these changes to our cardiology colleagues?, CURR OPIN C, 16(2), 2001, pp. 126-135
Citations number
38
Language
INGLESE
art.tipo
Review
Categorie Soggetti
Cardiovascular & Respiratory Systems
Journal title
CURRENT OPINION IN CARDIOLOGY
ISSN journal
0268-4705 → ACNP
Volume
16
Issue
2
Year of publication
2001
Pages
126 - 135
Database
ISI
SICI code
0268-4705(200103)16:2<126:ATIFTV>2.0.ZU;2-I
Abstract
The indications for tissue valves in the aortic and mitral positions are be coming better defined with advances in valve design, valve preservation, an d management of reoperations. Although some patients who require cardiac va lve replacement clearly benefit more from one type of valve than from anoth er, not infrequently one encounters a patient who is in the "gray zone," wh ere the optimal choice is difficult. At present, bioprostheses for the dise ased aortic valve include stented porcine and pericardial valves, stentless porcine valves, aortic homograft, and pulmonary autograft. For patients wi th mitral valve disease, options for tissue valve replacement are a stented porcine or pericardial prosthesis. Generally, factors to consider in choos ing the appropriate valve substitute include the patient's age, expected li fe expectancy, coexisting medical problems, lifestyle, and socioeconomics; the etiology of the valve disease, annular size, and physician and patient preference are also relevant. Despite the known finite durability of tissue valves, which is the main limitation in their use, the long-term results h ave been satisfactory, particularly in older patients, patients with a limi ted life expectancy, and those undergoing valve replacement in the aortic p osition. Distillation of available information and ongoing communication be tween the surgeon and the cardiologist will enable us to assist the patient in choosing the best valve substitute. Curr Opin Cardiol 2001, 16:126-135 (C) 2001 Lippincott Williams & Wilkins, Inc.