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"Histoire de Valves"

"Histoire de Valves". Rémi NOTTIN. AFICCT, Tours, Vendredi 13 juin 2014. La chirurgie cardiaque à cœur fermé. La Commissurotomie Mitrale "à cœur fermé". Sir Henry Souttar : 1925, dilatation au doigt

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"Histoire de Valves"

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  1. "Histoire de Valves" Rémi NOTTIN AFICCT, Tours, Vendredi 13 juin 2014

  2. La chirurgie cardiaque à cœur fermé

  3. 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.

  4. C.P. Bailey : 1948 Ch. Dubost :1953

  5. Ecole Broussais Charles Dubost Ecole Laennec Jean Mathé

  6. Contre-indicationde la commissurotomie à cœur fermé

  7. La Commissurotomie Mitrale "à cœur ouvert"(1956)

  8. La Commissurotomie Mitrale "à cœur fermé" va devienir :" La valvuloplastie Mitrale percutanée" Rémi NOTTIN 1983

  9. La valvuloplastie Mitrale percutanéeavec le ballon d’Inoue (1990) Inoue  K; Clinical application of transvenous mitral commissurotomy, JTCS , 1984

  10. LES PROTHESES VALVULAIRES MECANIQUES ATS Valves à doubles ailettes SorinBicarbon Carbomedics St Jude Medical MedtronicHall Kaster Valves à disque Monostrut Bjork-Shiley Convexo-concave BjorkStandart STARR Smeloff Cutter 1965 1970 1980 1985 1994

  11. Lowell EDWARDS

  12. Valvede Hufnagel 1952 : 1ère valve artificielle

  13. Valves de Starr Mitrales

  14. Starr-Edwards caged ball valves 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.

  15. Comparaison entre SMELOFF CUTTER et STARR EDWARDS

  16. LES PROTHESES VALVULAIRES MECANIQUES ATS Valves à doubles ailettes SorinBicarbon Carbomedics St Jude Medical MedtronicHall Kaster Valves à disque Monostrut Bjork-Shiley Convexo-concave BjorkStandart STARR Smeloff Cutter 1965 1970 1980 1985 1994

  17. 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.

  18. BjorkShiley avec disque en Delrin

  19. 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)

  20. BjorkShileyConvexo-concave avec disque en carbone Pyrolitique

  21. Björk-Shiley Convexo-Concave valve: The (Really) Bad News • First outlet strut fracture in 1978 during clinical trials

  22. Valve Medtronic Hall (Hall Kaster) Valve du Cardiowest

  23. LES PROTHESES VALVULAIRES MECANIQUES ATS Valves à doubles ailettes SorinBicarbon Carbomedics St Jude Medical MedtronicHall Kaster Valves à disque Monostrut Bjork-Shiley Convexo-concave BjorkStandart STARR Smeloff Cutter 1965 1970 1980 1985 1994

  24. St Jude Medical 1977

  25. CARBOMEDICS CARBOMEDICS

  26. On-X’s Mitral valve Autres valves à double ailettes ATS = Medtronic Open Pivot

  27. Quelquescuriosités ….

  28. Quelquescuriosités …. Harken Kay-Shiley

  29. Quelques valves défaillantes Beall Servelle

  30. HOMOGREFFES : 1962 D. Ross et Barratt-Boyes

  31. Bioprothèses porcines avec stent Carpentier- Edwards Supra-annulaire 1981 Carpentier- Edwards Standard 1975 Hancock 1971 Intact 1983 Epic JM

  32. Bioprothèses porcines stentless Racines aortiques Freestyle Medtronic 1992 Prima Edwards

  33. Bioprothèses péricardiques avec stent Perimount Carpentier Edwards 1981 Ionescu-Shiley 1971 Trifecta SJM Mitroflow 1982

  34. Bioprothèses péricardiques stentless 3f ATS Pericarbon Sorin

  35. Valves sans sutures The Perceval S (Sorin) The 3f Enable (Medtronic) INTUITY (Edwards Lifesciences) Mc Govern

  36. Evolution des indications : valve mécanique vs valve biologique

  37. La chirurgie valvulaire en France est en expansion En 1994 : 31% sur 34000 CEC En 2011 : 45% sur 44718 CEC

  38. La chirurgie valvulaire en France 75% de prothèses biologiques contre 25% il y a 20 ans 50% de plasties mitrales contre 5% il y a 20 ans 12% de TAVI contre 0% il y a 20 ans

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