Jinko Zoki

The ATS valve was developed by Villafana, who also developed St. Jude Medical valve (SJM). First clinical trial was performed on May 1992. Since then, its clinical applications have been done more than 10, 000 cases in the world, centering on Europe. Several studies have been reported as for its anti-thorombogenicity, hemolysis, less noise. Since September 1993 to June 1994, 16 patients underwent valve replacement, using ATS valve in our institute. We evaluated this valve function by continuous wave Doppler echo-cardiography one year after operation. The result showed the same compared with SJM. In aortic position, the result showed lower peak gradient, particularly in 23mm size (ATS valve; 8.9±1.6mmHg, SJM valve; 22.3±6.6mmHg), comparing with the SJM valve. In conclusion, this new valve showed superior valve function with low pressure gradient in echo-cardiographic viewpoint, indicating equivalent to that of SJM.

View full abstract

Show abstractHide abstract

To assess the biocompatibility of covalently-bonded, heparin-coated, cardiopulmonary bypass circuits (CPB), we compared a control CPB group (C group) with a heparin-coated CPB (H group) in elective CABG operations. Method: Fourteen patients who underwent CABG were randomly divided between the C group (n=7) and the H group (n=7). The CPB circuits included a membrane oxygenator (Maxima) and a centrifugal pump (Biopump). In the H group, heparin (3mg/kg) was administered to maintain an activated clotting time (ACT) greater than 480s. Measurements of blood samples were taken both preoperatively and during CPB to assess the values of the following: thrombin-antithrombin III complex (TAT), fibrinogen, antithrombin (AT)-III, plasminogen activator inhibitor-1 (PAT-1), α₂-plasmin inhibitor plasmin complex (PIC), fibrinogen degradation product (FDP), fibrinopeptide Bβ_15-42, C3, C4, β-thromboglobulin, platelet factor IV, 6-keto-PGF_1β, thromboxane B₂, myeloperoxidase, and free hemoglobin. Also, morphologic examinations of platelets on the surface of CPB circuits were performed, using a scanning electron microscope (SEM). Results: Compared with the C group, the H group showed significant suppression of the titers in TAT and PAT-1 (p<0.013 and p<0.019, respectively). The SEM survey also revealed significant suppression of morphologic changes in surfaceadhesive platelets in the H group. Conclusions: Considering biocompatibility in open heart surgery, some values of coagulation, fibrinolysis, and platelet activation were found to be preferable in heparin-coated CPB.

View full abstract

Download PDF (3469K)

Register with J-STAGE for free!