Technical Details of Redo Aortic Valve Replacement using St. Jude Medical Mechanical Prosthesis in a Patient with Thrombosed Aortic Mechanical Prosthesis: A Video Presentation

Ujjwal K Chowdhury,Niraj Nirmal Pandey,Sumanth Raghuprakash,Shikha Goja,Shweta Sharma,Niwin George,Lakshmi Kumari Sankhyan,Somya Gupta

doi:10.31579/2641-0419/224

Abstract

Current consensus guidelines of the AHA and ESC, uniformly recommend either type of prosthetic valve for patients aged 60 to 70 years and mechanical prosthesis for patients aged less than 60 years

Highlights

Current consensus guidelines of the AHA and ESC, uniformly recommend either type of prosthetic valve for patients aged 60 to 70 years and mechanical prosthesis for patients aged less than 60 years. [1,2,3,4] These recommendations are based on the results of 4 randomized controlled trials that demonstrated no significant difference in late survival. [2,3,4,5,6] Two of these trials compared mechanical and bioprosthetic valve models implanted in 1970s and 1980s. [5,6,7] The other 2 trials included patients undergoing aortic valve replacement
Valve replacement in young adults entails a choice between a mechanical prosthesis with risks of anticoagulation-related bleeding/thrombosis versus bioprosthesis necessitating eventual reoperation
Patients who do not respond within 48-72 hours should be referred for surgery because these patients may have tissue ingrowth obstructing the prosthetic valve (Panus formation) and usually do not respond to continued thrombolytic treatment

Summary

Introduction

Current consensus guidelines of the AHA and ESC, uniformly recommend either type of prosthetic valve for patients aged 60 to 70 years and mechanical prosthesis for patients aged less than 60 years. [1,2,3,4] These recommendations are based on the results of 4 randomized controlled trials that demonstrated no significant difference in late survival. [2,3,4,5,6] Two of these trials compared mechanical and bioprosthetic valve models implanted in 1970s and 1980s. [5,6,7] The other 2 trials included patients undergoing aortic valve replacement. Current consensus guidelines of the AHA and ESC, uniformly recommend either type of prosthetic valve for patients aged 60 to 70 years and mechanical prosthesis for patients aged less than 60 years. [5,6,7] The other 2 trials included patients undergoing aortic valve replacement.

Results

Conclusion