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Article

Evolution à moyen terme et rôle de l’échocardiographie après Remplacement Valvulaire

by
Stéphane Zaza
1,*,
Andres Jaussi
2,
Jean Crittin
3 and
Antoine Bloch
1
1
Département cardiovasculaire de la Tour, av. J.-D. Maillard, Meyrin, Switzerland
2
Les Arcades, Yverdon, Switzerland
3
Sion, Switzerland
*
Author to whom correspondence should be addressed.
Cardiovasc. Med. 2007, 10(7), 236; https://doi.org/10.4414/cvm.2007.01261
Submission received: 24 May 2007 / Revised: 24 June 2007 / Accepted: 24 July 2007 / Published: 24 August 2007

Abstract

Aims: The aim of the study was to evaluate the rate of occurrence of complications associated with prosthetic valves (PV) in ambulatory practice and to further evaluate the usefulness of echocardiography in the diagnosis and follow- up of these complications. Method: The study included 226 patients with a mean age of 57.7 ± 14.7 years in whom 253 PV (209 mechanical and 44 biological) were implanted. Immediate post-operative echocardiography was performed followed by annual echographic control studies. Results: Mean follow-up was 6.8 ± 3.8 years, corresponding to 1526 patient years. Complication-free patients numbered 72.7 ± 3.5% in the presence of mechanical prosthetic valves (MV) and 68.6 ± 8.1% in the presence of biological valves (BV) (p = 0.55). With respect to positions, complication-free patients numbered 68.3 ± 4.0%, 85.3 ± 4.8% and 51.9 ± 15% with PV in the aortic, mitral and mitro-aortic positions respectively (p = 0.54). The haemorrhagic and endocarditic risk was most important in the presence of a MV. All cases of PV degeneration occurred in patients with a BV in the mitral position. There was a tendency towards an increased incidence of paravalvalvular leaks and re-interventions in the presence of BV and a tendency towards an increased incidence of thrombo-embolic complications with PV in the aortic position. A PV linked complication was detected on average every 24.4 echocardiographs. Conclusion: The incidence of PV linked complications is low with a majority of patients free of any complications following valve replacement. The type and position of the PV only appears to influence the incidence of haemorrhages, degenerescence, re-intervention and endocarditis. The usefulness of routine echocardiographic follow-up therefore seems limited. An echocardiographic follow-up is, however, justified in certain settings, namely in the presence of para-valvular leaks, increased trans-valvular gradients, unfavourable clinical evolutions and in cases of a multiple year old BV.
Keywords: valve replacement; prostehtic valve; postreplacement complications valve replacement; prostehtic valve; postreplacement complications

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MDPI and ACS Style

Zaza, S.; Jaussi, A.; Crittin, J.; Bloch, A. Evolution à moyen terme et rôle de l’échocardiographie après Remplacement Valvulaire. Cardiovasc. Med. 2007, 10, 236. https://doi.org/10.4414/cvm.2007.01261

AMA Style

Zaza S, Jaussi A, Crittin J, Bloch A. Evolution à moyen terme et rôle de l’échocardiographie après Remplacement Valvulaire. Cardiovascular Medicine. 2007; 10(7):236. https://doi.org/10.4414/cvm.2007.01261

Chicago/Turabian Style

Zaza, Stéphane, Andres Jaussi, Jean Crittin, and Antoine Bloch. 2007. "Evolution à moyen terme et rôle de l’échocardiographie après Remplacement Valvulaire" Cardiovascular Medicine 10, no. 7: 236. https://doi.org/10.4414/cvm.2007.01261

APA Style

Zaza, S., Jaussi, A., Crittin, J., & Bloch, A. (2007). Evolution à moyen terme et rôle de l’échocardiographie après Remplacement Valvulaire. Cardiovascular Medicine, 10(7), 236. https://doi.org/10.4414/cvm.2007.01261

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