Ten Years Experiences of ATS Mechanical Valve / 대한흉부외과학회지

ABSTRACT

BACKGROUND: This study is to evaluate the safety of ATS valve by examining the clinical results of ten-years experience. MATERIAL AND METHOD: From July 1995 to March 2005, we reviewed 305 patients with ATS valve implantation. Mean age was 49.8+/-11.7 years and 140 (45.6%) males were included. Etiologies were rheumatic diseases in 207 cases (67.4%), degenerative changes in 57 cases (18.6%), valve dysfunction in 23 cases (7.5%) and infective endocarditis in 14 cases (4.6%). AVR was performed in 72 patients (23.5%), MVR in 156 patients (50.8%), DVR (AVR+MVR) in 63 patients (20.5%) and TVR in 16 patients (5.2%). RESULT: There were 9 operative mortalities (2.9%). Follow up period was 56.5+/-34.0 (0~115) months and 96.4% patients were followed up with 9 late deaths. Five and ten years survival rates were 94.9 +/-1.3%, 91.2+/-2.3% using Kaplan-Meier's methods. Valve related event free survival rates in 5 and 10 years were 90.8+/-2.0% and 86.9+/-3.2%. There were 16 anticoagulation-related hemorrhages, 6 thromboembolisms, 3 prosthetic valve endocarditis and 1 paravalvular leakage. NYHA class improved after operation (p <0.05). Postoperative echocardiography showed significant decrease in LA size, LVEDD and LVESD (p <0.01). Patients with 19 and 21 mm valve showed significantly higher transvalvular pressure gradient in aortic position (p <0.001, p <0.001). CONCLUSION: ATS valve showed good hemodynamic results with few valve related complications and thus can be used with acceptable risk.