ATS 기계 판막의 10년 임상경험

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.