Abstract
Incomplete opening of the Omniscience(OS) prosthtic valve in mitral position is widely known phenomenon. Among 29 hospital survivers who were implanted with the OS valves in mitral position, cineradiographic examination between 1984 and 1988 showed poor opening of the valve below 40°C in 15 cases out of 25 examinees. These 15 patients were followed up and re-evaluated in September 1991. One patient died suddenly during follow up time. Two patients underwent emergency valve re-replacement due to thrombosed valves. Two cases gradually deteriorated to NYHA class III because of undue transvalvular pressure guradient, and one of these cases improved after re-MVR. No foreign body interfering valve motion such as thrombus or overgrown pannus was seen in this case. Peak pressure gradients and effective orifice area of the OS valves were 13.5±3.0mmHg and 1.2±0.5cm (mean±SD, n=11) with continuous wave doppler echocardiographic examination. Cineradiographic re-examination showed decrease in opening angles more than 5° in 4 cases. Poorly opening OS valves in mitral position are moderately to severely obstructive to blood flow causing heart failure in some cases.
