"Histoire de Valves" Rémi NOTTIN AFICCT, Tours, Vendredi 13 juin 2014.
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"Histoire de Valves" Rémi NOTTIN AFICCT, Tours, Vendredi 13 ju
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Transcript of "Histoire de Valves" Rémi NOTTIN AFICCT, Tours, Vendredi 13 juin 2014.
"Histoire de Valves"
Rémi NOTTINAFICCT, Tours, Vendredi 13 juin 2014
La chirurgie cardiaque à cœur fermé
Canal artériel 1938 Robert GROSS Boston Children Hospital
Coarctation 19441945
Clarence CRAFOORDRobert GROSS et HUFNAGEL
StockholmBoston
Tétralogie de Fallot 1944 BLALOCK-TAUSSIG BaltimoreJohn‘s Hopkins Hospital
Rétrécissement mitral 19251948
Henry SOUTTARCP BAILEY Philadelphie
La Commissurotomie Mitrale "à cœur fermé"
• Sir Henry Souttar : 1925, dilatation au doigt
• C.P. Bailey en 1948 effectue plusieurs
dilatations mitrales, qu’il nomme "commissurotomies". Il est suivi par Harken et Brock.
C.P. Bailey : 1948 Ch. Dubost :1953
Ecole BroussaisCharles Dubost
Ecole LaennecJean Mathé
Contre-indicationde la commissurotomie à cœur fermé
La Commissurotomie Mitrale "à cœur ouvert"(1956)
La Commissurotomie Mitrale "à cœur fermé" va devienir :
" La valvuloplastie Mitrale percutanée"
Rémi NOTTIN1983
La valvuloplastie Mitrale percutanéeavec le ballon d’Inoue (1990)
Inoue K; Clinical application of transvenous mitral commissurotomy, JTCS , 1984
LES PROTHESES VALVULAIRES MECANIQUESLES PROTHESES VALVULAIRES MECANIQUES
1965 199419801970 1985
Bjork Standart
Convexo-concave
Monostrut
Medtronic Hall Kaster
St Jude Medical
Carbomedics
Bjork-Shiley
Valvesà doublesailettes
STARRSTARR Smeloff CutterSmeloff Cutter
Valvesà disque
Sorin Bicarbon
ATS
Lowell EDWARDS
Valve de Hufnagel
1952 : 1ère valve artificielle
Valves de Starr Mitrales
The original Starr-Edwards mitral valve, implanted 1960. Lucite cage, Silastic rubber ball occluder.
Starr-Edwards Model 1260 introduced 1968. Teflon and polypropylene sewing ring, cast Stellite 21 cage. Still in use.
Starr-Edwards 2400 introduced 1972. Hollow Stellite ball, cloth covered Stellite cage. Discontinued 1980.
Starr-Edwards caged ball valves
Comparaison entre SMELOFF CUTTER et STARR EDWARDS
LES PROTHESES VALVULAIRES MECANIQUESLES PROTHESES VALVULAIRES MECANIQUES
1965 199419801970 1985
Bjork Standart
Convexo-concave
Monostrut
Medtronic Hall Kaster
St Jude Medical
Carbomedics
Bjork-Shiley
Valvesà doublesailettes
STARRSTARR Smeloff CutterSmeloff Cutter
Valvesà disque
Sorin Bicarbon
ATS
Björk-Shiley Tilting Disc Valves Donald P. Shiley, an engineer in Santa Ana, CA with a
garage Late 1960’s began developing heart valves Viking O. Björk, a Swedish heart surgeon came on board
a few years later
Radial-spherical (R/S) valve introduced in 1974. Subjected to several design changes. Flat occluder disc, originally of Delrin, later changed to pyrolytic carbon. Stellite housing. Opens to 50-60 degrees. Inlet and outlet struts are welded to the flange. Early failures of the inlet strut welds were eliminated with a change to the welding process.
Bjork Shiley avec disque en Delrin
Björk-Shiley Convexo-Concave valve: The Good News
C/C disc improves hemodynamics—decreased complications due to thromboembolism (TE)
Received FDA approval in 6 months Became the most popular valve in the
world (ultimately represented half of all valves implanted)
Bjork Shiley Convexo-concaveavec disque en carbone Pyrolitique
Björk-Shiley Convexo-Concave valve: The (Really) Bad News
First outlet strut fracture in 1978 during clinical trials
Valve Medtronic Hall (Hall Kaster)
Valve du Cardiowest
LES PROTHESES VALVULAIRES MECANIQUESLES PROTHESES VALVULAIRES MECANIQUES
1965 199419801970 1985
Bjork Standart
Convexo-concave
Monostrut
Medtronic Hall Kaster
St Jude Medical
Carbomedics
Bjork-Shiley
Valvesà doublesailettes
STARRSTARR Smeloff CutterSmeloff Cutter
Valvesà disque
Sorin Bicarbon
ATS
St Jude Medical1977
CARB
OM
EDIC
S CARBOM
EDICS
On-X’s Mitral valveATS = Medtronic Open Pivot
Autres valves à double ailettes
Quelques curiosités ….
Quelques curiosités ….
Harken Kay-Shiley
Quelques valves défaillantes
Beall Servelle
HOMOGREFFES : 1962 D. Ross et Barratt-Boyes
Bioprothèses porcinesavec stent
Carpentier- EdwardsStandard
1975
Carpentier- EdwardsSupra-annulaire
1981Hancock
1971
Epic JM Intact1983
Bioprothèses porcines stentlessRacines aortiques
FreestyleMedtronic
1992
Prima Edwards
TrifectaSJM
Perimount Carpentier
Edwards1981
Bioprothèses péricardiquesavec stent
Ionescu-Shiley1971
Mitroflow1982
Bioprothèses péricardiques stentless
3f ATSPericarbonSorin
Valves sans suturesThe 3f Enable (Medtronic)
The Perceval S (Sorin)
INTUITY (Edwards Lifesciences)
Mc Govern
Evolution des indications : valve mécanique vs valve biologique
La chirurgie valvulaire en Franceest en expansion
En 1994 : 31% sur 34000 CEC
En 2011 : 45% sur 44718 CEC
La chirurgie valvulaire en France
75% de prothèses biologiquescontre 25% il y a 20 ans
50% de plasties mitralescontre 5% il y a 20 ans
12% de TAVI contre 0% il y a 20 ans
