Clinical experience with the Lillehei-Kaster valve and the Hall-Kaster valve

概要

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The Lillehei-Kaster valves were used in 11 patients and the Hall-Kaster valves were used in 35 patients. The Lillehei-Kaster valves has not undergone any changes in design or materials since its introduction into clinical use in 1970. AVR with the Lillehei-Kaster valve was done in 11 patients (mean age 39.6 y/o). One patients died in early postoperative periodes for valve unrelated origin (mortality rate=9.1%). The Hall-Kaster valve was introduced in 1977. The free-floating rotatable disc opens to a maximal angle of 75 degrees to the plane of the orifice, being controlled by the disc guide strut which passes through the central aperture of the disc. AVR with the Hall-Kaster valve was done in 26 patients, and MVR with the Hall-Kaster valve was done in 9 patients (mean age: 37.7 y/o). Four operative deaths and one early death amounted to (mortality rate=14.9%). However every origin was not related to the prosthetic valve. Anticoagulant therapy had been done postoperatively in every cases. One coronary embolization occured 6 months after AVR with the Hall-Kaster 23A. Postoperative evaluation revealed improvement of CTR, cardiac index, and pulmonary wedge pressure in both valves. Clinical findings improved, too. In the patients who were operated on MVR with the Hall-Kaster 29M, MVG was 5.1 mmHg and MVA was 2.0 cm2 on an average by the Gorlin & Gorlin's formula.