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Author Sankarkumar, R. ♦ Bhuvaneshwar, G. S. ♦ Magotra, R. ♦ Muralidharan, S. ♦ Rajan, R. S. ♦ Saha, D. ♦ Rao, K. S. V. K. S. ♦ Valiathan, M. S. ♦ Radhakrishna, S. ♦ Ramani, A. V.
Source Sree Chitra Tirunal Institute for Medical Sciences & Technology
Content type Text
Publisher Journal of Heart Valve Disease
File Format PDF
Language English
Subject Domain (in DDC) Technology ♦ Medicine & health ♦ Surgery & related medical specialties
Subject Domain (in MeSH) Equipment and Supplies ♦ Analytical, Diagnostic and Therapeutic Techniques and Equipment
Subject Keyword Medical Devices
Abstract Background and aim of the study: The Chitra tilting disc valve was developed in India to meet the need for a low-cost cardiac valve. The valve has an integrally machined cobalt-based alloy cage, an ultrahigh molecular-weight polyethylene disc, and a polyester suture ring. An important feature of this valve is its soft closing sound, by virtue of a plastic occluder.Methods: Between December 1990 and January 1995, 306 patients underwent isolated aortic MR, n = 101) or mitral valve replacement (MVR, n = 205) at six institutions in India. The early mortality rate was 6.9% (seven after AVR; 14 after MVR). A total of 285 survivors was followed up until September 1998; total follow up was 1212 patient-years (pt-yr) (AVR, 445 pt-yr; MVR, 767 pt-yr).Results: There were 52 late deaths (4.3%/pt-yr; AVR 2.2%/pt-yr; MVR 5.5%/pt-yr). Thirty-five deaths were valve-related (23 were due to unknown causes). One AVR patient (0.2%/pt-yr) and 12 MVR patients (1.6%/pt-yr) developed valve thrombosis, and embolic episodes occurred in 25 patients (seven after AVR, 1.6%/pt-yr; 18 after MVR, 2.4%/pt-yr). Bleeding events and infectious endocarditis occurred infrequently (AVR 0.9 and 0.7%/pt-yr; MVR 0.4 and 0.5%/pt-yr, respectively). There was no incidence of paravalvular leak or structural dysfunction of the valve. Actuarial survival rates at seven. years were 82.4 +/- 4.0% for AVR and 65.2 +/- 5.0% for MVR. During the same interval, thrombus-free and embolism-free survival after AVR and MVR occurred in 98.9 +/- 1.1% and 94.1 +/- 1.9%, and 92.3 +/- 2.8% and 82.1 +/- 5.7% of patients, respectively. Freedom from all valve-related mortality and morbidity at seven years was 81.5 +/- 4.1% after AVR, and 64.2 +/- 5.1% after MVR.Conclusion: The Chitra valve appears to be safe and to have performance comparable with that of other currently used tilting disc valves. This valve costs substantially less than other valves, and is therefore within reach of a larger subset of Indian patients.
Education Level UG and PG
Learning Resource Type Article
Educational Framework Medical Council of India (MCI)
Journal JOURNAL OF HEART VALVE DISEASE
Volume Number 10
Issue Number 5
Page Count 9
Starting Page 619
Ending Page 627