ISSN : 1301-5680
e-ISSN : 2149-8156
TURKISH JOURNAL OF
THORACIC AND
CARDIOVASCULAR SURGERY
Turkish Journal of Thoracic and Cardiovascular Surgery     
DO THE SILVER COATED SILZONE VALVES CAUSE AN INCREASE IN THE MIDTERM PARAVALVULAR LEAK INCIDENCE RELATED TO OTHER ST. JUDE VALVES?
Denyan Mansuroğlu, Deniz Göksedef, Vedat Erentuğ, Hasan Basri Erdoğan, *Akın İzgi, Kaan Kırali, Gökhan İpek, Cevat Yakut
Koşuyolu Kalp Eğitim ve Araştırma Hastanesi, Kalp Damar Cerrahisi Kliniği, İstanbul
*Koşuyolu Kalp Eğitim ve Araştırma Hastanesi, Kardiyoloji Kliniği, İstanbul
Backgraound: Mechanical valve replacement in native valvular endocarditis is known to increase the recurrence of endocarditis and incidence of paravalvular leak. Aim of our study was to evaluate midterm results of Silzone valvular prosthesis manufactured and presented as resistant to infections and used in patients with infective endocarditis in our center.

Methods: Twentysix patients with the same demographic findings, who had mechanical valve replacement due to infective endocarditis between 1998 - 2000, were included in this study. Nineteen of the patients were male and remaining 7 were female, with an average age of 42.35 ± 13.6 years (17-80). In 12 of these patients, mechanical valve replacement by Silzone valvular prosthesis was performed (Group S). Control group consisted of the remaining 14 patients who received mechanical valve replacement by St Jude mechanical valvular prosthesis (Grup K). In Group S, six patients received aortic valve replacement, three mitral valve replacement, and three patients both mitral and aortic valve replacement. Average follow-up time of the patients was 38.23 ± 19.89 months.

Results: No early mortality was seen in both groups. Late mortality was seen only in one patient in Group S (8.33%) ( p= 0.481). In all patients, paravalvular leak was detected in four patients (33.3%). All of the paravalvular leak detected patients belonged to Group S ( p = 0.02). One of the patients needed reoperation due to paravalvular leak ( p = 0.417) and it was repaired using three separated single sutures. There was no significant difference in ventricular and left atrial diameters and ejection fraction between two groups.

Conclusions: In our study, there seems to be an increase in the incidence of paravalvular leak significantly in Silzone group. However, the degree of leakage was low and paravalvular leak was persistent in the reoperated patient. Morover the number of valves used is not enough to evalute the condition. Thus we believe that the Silzone valvular prosthesis may not cause an increase in mortality an morbidity and the incidence of reoperations.

Keywords : Endocarditis, paravalvular leak, silzone
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