Factors influencing thromboembolic complications in Omniscience cardiac valve patients

Aortic valve replacement with omniscience and omnicarbon valves

Clinical results achieved in 100 cases of aortic valve replacement with the Omniscience (O-S) valve during the period from 1980 to 1985 as well as 100 cases of aortic valve replacement with the Omnicarbon (O-C) valve during the period from 1985 to 1989 were studied. Concomitant surgical procedures including mitral valve replacement were performed in 63 patients in the O-S group and 67 patients in the O-C group. Cumulative follow-up in the two groups was carried out for a total of 559 and 273 patient-years, respectively. The overall 4-year actuarial survival rate was 82% +/- 3.8% in the O-S group and 89.5% +/- 3.2% in the O-C group, the corresponding rates for patients undergoing isolated aortic valve replacement being 82.9% +/- 4.2% in the O-S group and 91.9% +/- 3.5% in the O-C group. The overall 4-year actuarial event-free rate with respect to thromboembolic complications was 88.8% +/- 3.3% in the O-S group and 94.4% +/- 2.8% in the O-C group, as compared with the corresponding rates of 89.2% +/- 3.6% in the O-S group and 95.9% +/- 2.8% in the O-C group for patients undergoing isolated aortic valve replacement. The overall rate of valve-related complications, including thromboembolism, anticoagulant-related hemorrhage, perivalvular leak, infection, and structural failure, was 78.8% +/- 4.2% in the O-S group and 89.3% +/- 3.5% in the O-C group (p less than 0.05), and for isolated aortic valve replacement, 79.7% +/- 4.5% in the O-S group and 89.6% +/- 4.1% in the O-C group.(ABSTRACT TRUNCATED AT 250 WORDS)

Tissue and mechanical valves: mutually advantageous interplay

This report is concerned with the dynamic interplay between glutaraldehyde preserved tissue valves (bioprostheses) and mechanical valves. These two classes of valve replacement devices are not competitive, but provide some nonoverlapping characteristic advantages and disadvantages. By proper selection, it may be possible to tailor the kind of device used for a particular patient, thus improving the overall results of bioprosthetic and mechanical valve replacement. Careful selection of patients according to age and the safety of anticoagulation should achieve a series of patients with mechanical and bioprosthetic valves that would be superior to a series in which all patients received a single device. Thus, these devices should be viewed as complimentary rather than competitive since the value of properly matching a prosthesis to the patient will be reflected in improved overall results with each class of prosthesis.

Clinical evaluation of the Omniscience aortic disc valve prosthesis

The clinical results and hemodynamics were evaluated in 100 cases of aortic valve replacement, using the Omniscience valve, in the period December 1980 through 1984. Late survival rate, clinical improvement and cardiac and prosthetic valve performance were acceptably satisfactory. The overall incidence of thromboembolism was 4.7%/patient year. The opening angle of the disc was less than 60 degrees in 18% of the studied cases. Further investigations are required to determine if such results were related to the valve structure or to some cause in the recipient. Assessment of the durability of the Ominiscience cardiac valve prosthesis must await the results of long-term observation.