Prothèse valvulaire cardiaque; Remplacement valvulaire aortique; Obstacle à l’éjection ventriculaire; Heart valve prosthesis; Aortic valve replacement; Left ventricular outflow tractobstruction
Abstract :
[fr] La prévalence des valvulopathies atteint 2,5% dans la population générale. Le remplacement valvulaire aortique est l’une des procédures chirurgicales les plus courantes. Nous rapportons l’histoire d’une patiente dont la valve aortique mécanique, mise en place à l’âge de 54 ans lors d’une intervention de réparation mitrale, a dû être remplacée 14 ans plus tard en raison de la formation d’un pannus sous-valvulaire rétrécissant l’orifice valvulaire. Nous profitons de cette histoire clinique pour comparer les avantages et inconvénients respectifs de la plastie, du remplacement par valve biologique et du remplacement par valve mécanique, et donner les arguments les plus récents pour le choix de la prothèse la plus adaptée à un profil de patient particulier. [en] The prevalence of valvular heart diseases reaches 2.5% in the overall population. Aortic valve replacement is one of the most common surgical procedures. We report the story of a female patient whose aortic mechanical valve, implanted at the age of 54 years at the time of a mitral valve repair surgery, had to be replaced 14 years later, due to the development of a subvalvular pannus narrowing the valvular orifice. We use this clinical story to compare the advantages and disadvantages of repair surgery and valve replacement with a biological or mechanical prosthesis, and summarize the latest evidence for the choice of the most adequate prosthesis for a particular patient’s profile.
Disciplines :
Surgery Cardiovascular & respiratory systems
Author, co-author :
GREGOIRE, Céline ; Centre Hospitalier Universitaire de Liège - CHU > Frais communs médecine
Nellessen, Eric
Defraigne, Jean-Olivier ; Université de Liège - ULiège > Département des sciences cliniques > Chirurgie cardio-vasculaire et thoracique
RADERMECKER, Marc ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie cardio-vasculaire
Language :
French
Title :
La prothèse valvulaire idéale n’existe toujours pas. Quels facteurs entrent en compte pour orienter les choix d’une valve mécanique ou biologique ?
Alternative titles :
[en] The ideal valvular prosthesis still does not exist. Which factors come into consideration to guide the choices between mechanical and biologic valves ?
Publication date :
November 2014
Journal title :
Revue Médicale de Liège
ISSN :
0370-629X
eISSN :
2566-1566
Publisher :
Université de Liège. Revue Médicale de Liège, Liège, Belgium
Nkomo VT, Gardin JM, Skelton TN et al.- Burden of valvular heart diseases : a population-based study - Lancet, 2006, 368, 1005-1011.
Ismeno G, Renzulli A, Carozza A, et al.- Intravascular hemolysis after mitral and aortic valve replacement with different types of mechanical prostheses. Int J Cardiol, 1999, 69, 179-183.
Oxenham H, Bloomfield P, Wheatley DJ et al.- Twenty year comparison of a Bjork-Shiley mechanical heart valve with porcine bioprostheses. Heart, 2003, 89, 715-721.
Hammermeister K, Sethi GK, Henderson WG et al. - Outcomes 15 years after valve replacement with a mechanical versus a bioprosthetic valve : final report of the Veterans Affairs randomized trial. J Am Coll Cardiol, 2000, 36, 1152-1158.
Bonow RO, Carabello BA, Kanu C et al.- ACC/AHA 2006 guidelines for the management of patients with valvular heart disease : a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) : developed in collaboration with the Society of Cardiovascular Anesthesiologists: endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. Circul, 2006, 114, e84-231.
Vahanian A, Alfieri O, Andreotti F, et al.- Guidelines on the management of valvular heart disease (version 2012) : the task force on the management of valvular heart disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J, 2012, 33, 2451-2496.
van Geldorp MW, Eric Jamieson WR, Kappetein AP et al.- Patient outcome after aortic valve replacement with a mechanical or biological prosthesis : weighing lifetime anticoagulant-related event risk against reoperation risk. J Thorac Cardiovasc Surg, 2009, 137, 881-886.
Teshima H, Hayashida N, Yano H, et al.- Obstruction of St Jude Medical valves in the aortic position : histology and immunohistochemistry of pannus. J Thorac Cardiovasc Surg, 2003, 126, 401-407.
Barbetseas J, Nagueh SF, Pitsavos C, et al.- Differentiating thrombus from pannus formation in obstructed mechanical prosthetic valves: an evaluation of clinical, transthoracic and transesophageal echocardiographic parameters. J Am Coll Cardiol, 1998, 32, 1410-1417.
Montorsi P, De Bernardi F, Muratori M, et al.- Role of cine-fluoroscopy, transthoracic, and transesophageal echocardiography in patients with suspected prosthetic heart valve thrombosis. Am J Cardiol, 2000, 85, 58-64.
