BACKGROUND: Valvular heart disease is still the most common health problem i n Korea.By the end of the year 1999,there has been 94,586 cases of open heart surgery since the first case in 1958.Among them,36,247 cases were acquired heart diseases and 20,704 of those had valvular heart disease.But there was no database system and every surgeon and physician had great difficulties in analysing and utilizing those tremendous medical resources. Therefore,we developed a valve registry database program and utilize it for risk factor analysis and so on. MATERIAL AND METHOD: Personal computer-based multiuser database program was created using Microsoft AccessTM.That consisted of relational database structure with fine-tuned compact field variables and server-client architecture.Simple graphic user interface showed easy-to-use accessability and comprehensibility.User-oriented modular structure enabled easier modification through native AccessTM functions.Infinite application of query function aided users to extract, summarize,analyse and report the study result promptly. RESULT: About three-thousand cases of valve replacement procedure were performed in our hospital from 1968 to 1999.Total number of prosthesis replaced was 3,700.The numbers of cases for mitral,aortic and tricuspid valve replacement were 1600,584,76, respectively. Among them,700 patients received prosthesis in more than two positions. Bioprosthesis or mechanical prosthesis were used in 1,280 and 1,500 patients respectively. Redo valve replacements were performed in 460 patients totally and 40 patients annually. CONCLUSION: Database program for registry of valvular heart disease was successfully developed and used in personal computer-based multiuser environment.This revealed promising results and perspectives in database management and utilization system.
Bioprosthesis ; Heart ; Heart Diseases ; Heart Valve Diseases ; Humans ; Prostheses and Implants ; Risk Factors* ; Thoracic Surgery ; Tricuspid Valve

Aortic Valve ; Aortic Valve Stenosis/surgery* ; China ; Heart Valve Diseases/surgery* ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation ; Humans ; Transcatheter Aortic Valve Replacement ; Treatment Outcome

OBJECTIVE: To summarize the outcome of tricuspid valve replacement.
 METHODS: A total of 28 patients (15 males and 13 females) underwent tricuspid valve replacement from March 2000 to February 2015 in the First Affiliated Hospital of Zhengzhou University were recruited. Among them, 16 patients were Ebstein's anomaly, 7 had rheumatic valve heart disease, 3 and 2 suffered from infective endocarditis and degenerative tricuspid lesions, respectively.
 RESULTS: One patient died of multiple organ failure. Four patients were implanted permanent cardiac pacemaker because of third degree atrioventricular block occurring in the 5th day (2 patients) and in the 9th day (2 patients) after the operation, respectively. Twenty-seven patients were followed up from 1 month to 15 years. The prosthetic valves and permanent pacemakers worked well.
 CONCLUSION Third degree of atrioventricular block, mostly appearing in early postoperative period, is the most common and severe complication of tricuspid valve replacement. The key point for prevention of damage is to accurately identify the anatomical relationship among the tricuspid valve, atrioventricular node, and conduction bundle.
Ebstein Anomaly ; surgery ; Female ; Heart Valve Diseases ; surgery ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation ; Humans ; Male ; Pacemaker, Artificial ; Rheumatic Heart Disease ; surgery ; Tricuspid Valve ; pathology ; surgery

OBJECTIVETo analyze the clinical, echocardiographic features and therapy efficacy of patients with ruptured mitral chordae tendineae.

METHODSClinical data, echocardiographic and pathological results from 292 hospitalized patients with ruptured mitral chordae tendineae were retrospectively analyzed.

RESULTSThere were 99 cases (33.9%) with rupture of anterior leaflet and 180 cases (61.6%) with rupture of posterior leaflet, 13 cases (4.5%) with both anterior and posterior leaflet ruptures. Partial rupture of mitral chordae tendineae was found in 266 cases (91.1%) and total rupture in 26 cases (8.9%). Two hundred and fourteen cases (73.3%) were primary chordal rupture and 78 (26.7%) were secondary chordal rupture (P < 0.05). Primary chordal rupture was mostly due to mucus degeneration of the mitral valve, mostly presented as posterior leaflet rupture in aged male patients. Secondary chordal rupture was mostly caused by infective endocarditis, coronary heart disease, congenital heart disease and rheumatic heart diseases. Patients with secondary chordal rupture cases were significantly younger than patients with primary chordal rupture and there were significantly more anterior leaflet rupture than posterior leaflet rupture. One hundred and thirty patients received mitral valve reconstruction operation and another 110 underwent mitral valve replacement therapy and discharged complication free. The remaining 52 cases received medication therapy and discharged with improved symptoms (12 with mild chordal rupture without operation indication, 17 cases contraindicated to operative therapy, 7 cases transferred to other hospitals and 16 patients refused operation therapy).

CONCLUSIONSThe incidence of posterior leaflet rupture is higher than that of anterior leaflet rupture. Rupture of both anterior and posterior leaflet is rare and there are more primary chordal ruptures than secondary chordal ruptures based on our patient cohort. Mitral valve reconstruction operation and mitral valve replacement therapy are effective operative therapy options for the treatment of mitral chordal ruptures in indicated patients.

Chordae Tendineae ; Echocardiography ; Heart Valve Diseases ; Humans ; Mitral Valve ; surgery ; Mitral Valve Insufficiency ; surgery ; Mitral Valve Prolapse ; surgery

Objective: To compare the prognosis of transcatheter aortic valve replacement (TAVR) in patients with bicuspid aortic valve (BAV) or tricuspid aortic valve (TAV) stenosis. Methods: This was a retrospective study. Patients with symptomatic severe aortic stenosis, who underwent TAVR with follow-up time more than one year in Guangdong Provincial People's Hospital from April 2016 to August 2018, were included. According to aortic CT angiography, the patients were divided into BAV group and TAV group. The primary endpoint was the composite event of all-cause death and stroke, and the secondary endpoints were TAVR-related complications. Incidence of clinical endpoints and parameters derived from echocardiography were compared between the groups, and Kaplan-Meier survival analysis was used to compare the composite event between the two groups. Results: A total of 49 patients were included. The age was (73.6±6.3) years, and 25(51.0%) were male. There were 32 patients in BAV group and 17 in TAV group, the follow-up time was 466 (390, 664) days. The incidence of composite endpoint of death and stroke at one year were comparable in BAV and TAV groups (6.3% (2/32) vs. 5.9% (1/17), P=1.00). Kaplan-Meier curves also showed a similar risk of the composite endpoint(HR=1.03，95%CI 0.09-11.24，Log-rank P=0.98) between two groups. The incidence of all-cause death, stroke, myocardial infarction, severe bleeding, major vascular complications, new-onset atrial fibrillation or atrial flutter, and permanent pacemaker implantation were all similar between the two groups(all P>0.05), and there was no acute kidney injury (stage 2 or 3) in both groups. Echocardiographic parameters at one year were similar between the two groups (all P>0.05). Conclusions: The midterm prognosis of TAVR in patients with BAV and TAV stenosis is similar. Clinical trials of large sample size with long-term follow-up are warranted to verify our findings.
Aortic Valve/surgery* ; Aortic Valve Stenosis/surgery* ; Heart Valve Diseases ; Humans ; Male ; Retrospective Studies ; Transcatheter Aortic Valve Replacement ; Treatment Outcome

Humans ; Aortic Valve/surgery* ; Heart Valve Diseases ; China ; Transcatheter Aortic Valve Replacement

Humans ; Aortic Valve/surgery* ; Heart Valve Diseases ; China ; Transcatheter Aortic Valve Replacement

From Feb. 1985 to Aug. 1996, 450 patients underwent open heart surgery with hypothermic cardiopulmonary bypass. In 450 cases of open heart surgery, 222 cases(49.3%) were congenital heart diseases and 228 cases(50.7%) were acquired heart diseases. In 222 cases of congenital heart diseases, there were 201 cases of acyanotic heart disease and 21 cases of cyanotic heart diseases. Among the 228 cases of acquired heart diseases, most cases were valvular heart diseases in which 206 valves were implanted. There were 32 cases of ischemic heart disease and the average graft anastomoses were 2.37 sites per operation. The operative mortality of congenital and acquired disease was 9.0% and 10.1% respectively and then overall mortality rate was 9.6%.
Cardiopulmonary Bypass ; Heart Diseases ; Heart Valve Diseases ; Heart* ; Humans ; Mortality ; Myocardial Ischemia ; Thoracic Surgery* ; Transplants

OBJECTIVE: To determine the surgical point and technique of artificial mechanical valve replacement in children with heart valve diseases. METHODS: From Jan. 1989 to Oct. 2005, 63 children under 15 years received mechanical cardiac valve replacement with cardiopulmonary bypass (CPB). RESULTS: The valve replacement included aortic valve replacement in 20 children, mitral valve replacement in 37 children and combined aortic valve and mitral valve replacement in 6 children. CONCLUSION The operation mortality was 7.94%(5/63). The follow-up periods were from 4 months to 204 months. The late mortality was 10.34%(6/58). All the other children were in NYHA class I - II. The operation mortality of children with heart valve replacement is higher than that of adults, but it was very effective.
Adolescent ; Aortic Valve ; surgery ; Cardiopulmonary Bypass ; Child ; Female ; Follow-Up Studies ; Heart Valve Diseases ; surgery ; Heart Valve Prosthesis Implantation ; methods ; Humans ; Male ; Mitral Valve ; surgery ; Treatment Outcome

Median sternotomy incision is world-widely used for open heart surgery, especially in valvular heart disease. But recently, minimally invasive approach by the right parasternal incision for valvular heart disease was introduced with the many merits by small incision. We experienced 1 case of mitral valve repalcement by right parasternal incision and extended transseptal approach. This technique has no specific complications or problems compared with the median sternotomy and was proven by the excellent exposure. Cosmetically, the patient was satisfied with the incision.
Heart Valve Diseases ; Humans ; Mitral Valve* ; Sternotomy ; Surgical Procedures, Minimally Invasive ; Thoracic Surgery