Selection and Complications of Prosthetic Heart Valves / 한양의대학술지

ABSTRACT

Due to development of new prosthetic heart valves(PHV) and advanced operative technology, the result of prosthetic valve replacement has improved, but problems such as thromboembolism, bleeding, structural valve deterioration, and patient-prosthesis mismatch are not yet resolved. The aging society, different life style and sensual change for life affected the type of operation and life quality after the operation. During four decades, the mechanical valve has been designed for less or no structural valve deterioration and manufacturers have mixed high-tech for prevention of thrombosis. However, the necessity of anticoagulation therapy is still remained. And the durability of the tissue valve has also been increased by development in technology of tissue preservation and fixation. But the risk of thromboembolism and structural failure is not completely resolved and it is far from perfect for replacing the mechanical valve. The long-term result of homograft is disappointing. However, the result of the pulmonary autograft is hopeful, except that it needs a very complex operation and therefore, it is limited to an experienced surgeon. Recent study shows that patient's characteristics are important to determine the long-term results and durability of the prosthetic valve. It needs to be reemphasized that, for better results of PHV replacement, we consider the patient's characteristics and types of PHV and discuss the options with our patients.