ABSTRACT
Biologic prostheses are generally considered to have superior antithrombotic properties but lack durability. We recommend biologic prostheses to elderly patients aged over 65 years old. The purpose of this report is to evaluate the midterm outcomes of aortic or mitral valve replacement with Carpentier-Edwards Pericardial Bioprosthesis (CEP) in patients younger than 60 years old. We performed valve replacement with CEP in 17 patients, aged 60 years or youngers, in the past 10 years. The survival rate and freedom from cardiac death at 9 years was 73.2% and 87.8%, respectively. There was no valve-related thromboembolism, anticoagulant-related hemorrhage, prosthetic valve endocarditis, structual valve dysfunction or re-operation. The midterm durability of the CEP in young patients was excellent. In selection of valve prosthesis, it is important to consider factors such as risk of re-operation as well as taking warfarins, and the patient's life style and wishes.
Subject(s)
Bioprosthesis , Heart Valve Prosthesis Implantation/mortality , Heart Valve Prosthesis , Adolescent , Adult , Aortic Valve/surgery , Female , Humans , Male , Middle Aged , Mitral Valve/surgery , Treatment OutcomeABSTRACT
Autopsy cases of myocarditis caused by Coxsackie viruses in two infants, aged 5 years and 10 months and 12 years, and two adults, aged 24 years and 45 years, were presented. Of the four cases, three revealed a rise in serum neutralization titer to Cox B,4 virus and one to both Cox B2 and Cox B4 viruses. Compared with the adult cases, the 2 infant cases showed less inflammatory response with relatively prominent hypertrophy in the heart. Both of the adult cases revealed intensive inflammatory reaction. Extensive inflammatory cell infiltration remained in one of the adult cases though the case survived about 4 years after manifestation of the infection, suggesting possible involvement of immunological factors.
