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Patient's Own Heart Valve is Best Replacement

by Rathi Manohar on August 3, 2010 at 7:51 PM
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 Patient's Own Heart Valve is Best Replacement

Replacing the aortic valve with the patient's own pulmonary valve is a better option for survival and quality of life, states a newly-released study.

Oxygen-rich blood in pumped via the aortic valve to nourish the body, while the pulmonary valve is the gateway for oxygen-depleted blood passing into the lungs.

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Defects and disease can create the need for the aortic valve to be replaced, a delicate but standard procedure for more than three decades.

The new valve may be mechanical -- which is sturdy but requires life-long medication to prevent blood clots -- or a graft, taken either from a cadaver or the living heart's other exit valve, which is subject to less stress.
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Earlier studies have not shown one method to be clearly superior to the others.

To compare the non-mechanical options for fixing aortic valves, researchers led by Sir Magdi Yacoub of Imperial College London fitted 108 patients with pulmonary valves removed from their own bodies, and another 108 with aortic valves taken from recently deceased donors.

All surgeries were open-heart.

After ten years, four patients had died in the so-called "autograft" or living valve group, as compared to 15 deaths in the "homograft" group that had been given a donor valve.

The survival rate, in other words, was 97 percent in the first cohort and 83 percent in the second.

"Our results support the hypothesis that a living valve implanted in the aortic position can lead to significantly improved clinical outcomes," the researchers said.

"The quality-of-life scores were also significantly better after the Ross operation," they added, referring to the name of the autograft procedure.

In the Ross technique, the removed pulmonary valve is replaced with the same part from a dead donor.

Yacoub conjectured that for the aortic valve, having one's own tissue somehow helped the body cope with the constant changes in pressure and size.

Source: AFP
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