Publications (3)0 Total impact
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Article: Rheumatic mitral valve repair: experience of 221 cases from Central Chest Institute of Thailand.
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ABSTRACT: Rheumatic heart disease is a major problem in Thailand and this region. Surgical management is still a dilemma and problematic. Current understanding of mitral valve complex and its dynamics in combination with improvement of surgical techniques allow surgeon to repair rheumatic mitral valve disease better. Several innovative approaches have been introduced recently and greatly enhances the success of mitral valve repair in this clinical entity. This case report reviews the authors' current approaches and results in the repair of rheumatic mitral valve at Central Chest Institute of Thailand.Journal of the Medical Association of Thailand = Chotmaihet thangphaet 08/2012; 95 Suppl 8:S51-7. -
Article: Patient-prosthesis mismatch has no influence on in-hospital mortality after aortic valve replacement.
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ABSTRACT: To analyze the relationship between prosthetic aortic valve orifice and body surface area (Effective Orifice Area Index, EOAI) and in-hospital mortality after aortic valve replacement. A prospective study was conducted between October 2007 to September 2010, 536 patients underwent isolated aortic valve replacement (AVR) was recorded on preoperative, operative and postoperative data. Patient Prosthesis Mismatch (PPM) was classified by Effective Orifice Area Indexed (EOAI) by prosthetic valve area divided by body surface area as mild or no significance if the EOAI is greater than 0.85 cm2/m2, moderate if between 0.65 cm2/m2 and 0.85 cm2/m2, and severe if less than 0.65 cm2/m2. Statistical differences were analyzed by Chi-square and student t-test with p-value less than 0.05 considered significant. There were 304 men, mean age was 60.98 years, mean valve orifice area 1.69 cm2, body surface area 1.60 m2, cross clamp time 1.13 hrs., bypass time 1.67 hrs. Mechanical valves were used in 274 patients (51.2%) and Bioprosthesis were used in 181 patients (48.8%). PPM was found in 33.7%, 6.7% was severe PPM, 27% was moderate PPM and 66.3% has no significant PPM Over all in-hospital mortality was 1.5%. There was no significant difference in hospital mortality between no PPM group, moderate PPM and severe PPM group (1.4% vs. 1.4% vs. 5.4%, p-value = 0.86). In a large aortic valve surgery population, moderate and severe patient prosthesis mismatch occurred in 35.6% of patients but had no influence on in-hospital mortality.Journal of the Medical Association of Thailand = Chotmaihet thangphaet 08/2012; 95 Suppl 8:S64-70. -
Article: Autologous pericardial valved conduit for the Ross operation.
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ABSTRACT: The feasibility and function of autologous pericardial valved conduit for right ventricular outflow tract reconstruction in the Ross operation were assessed. Between June 1997 and April 2002, 31 patients underwent this procedure at our institution; one was lost to follow-up. The other 26 males and 4 females were aged 17 to 60 years (mean, 36.6 years). Causes of aortic valve disease were infective endocarditis in 26 and rheumatic valve disease in 4. Mean follow-up was 16.7 months (range, 1-58 months). Preoperatively, 9 patients were in functional class II, 19 in class III, and 2 in class IV. Concomitant procedures included coronary artery bypass (1), mitral valve replacement (6), tricuspid valve replacement (1), and ventricular septal defect closure (1). Mean aortic crossclamp time was 199.4 min. There were 4 (13.3%) hospital deaths and no late death. Mean postoperative functional class was 1.17 with +0.36 aortic regurgitation, a peak gradient of 21.9 mm Hg (range, 6-59 mm Hg) across the conduit, and grade +0.96 pulmonary regurgitation. No conduit-related complication was detected. Use of autologous valved conduit for the Ross operation is feasible. Long-term follow-up is mandatory to assess durability.Asian cardiovascular & thoracic annals 01/2006; 13(4):321-4.
