HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Eugene H. Blackstone Joseph M. Craver William A. Baumgartner Scot A. Brewster Leonard H. Kleinman Nicholas G. Smedira Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Gillinov, A. M. Articles by Smedira, N. G. Search for Related Content PubMed PubMed Citation Articles by Gillinov, A. M. Articles by Smedira, N. G. Related Collections Valve disease

Ann Thorac Surg 2003;75:1175-1180
© 2003 The Society of Thoracic Surgeons

---

Original article: cardiovascular

The Carbomedics Top Hat supraannular aortic valve: a multicenter study

^a Department of Thoracic and Cardiovascular Surgery, Cleveland, Ohio USA
^b Department of Biostatistics and Epidemiology, The Cleveland Clinic Foundation, Cleveland, Ohio, USA
^c Department of Cardiac Surgery, Emory University, Atlanta, Georgia, USA
^d Department of Cardiac Surgery, The Johns Hopkins Hospital, Baltimore, Maryland, USA
^e La Jolla Cardiovascular and Thoracic Surgeons, La Jolla, California, USAUSA
^f Cardiovascular Surgery Associates of Milwaukee, Milwaukee, Wisconsin, USA

Accepted for publication June 26, 2002.

^* Address reprint requests to Dr Gillinov, Department of Thoracic and Cardiovascular Surgery, Desk 25, The Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH44195, USA
e-mail: gillinom{at}ccf.org

BACKGROUND: Introduced in 1993, the Carbomedics Top Hat (Sulzer, Carbomedics, Austin, TX) valve is a bileaflet mechanical aortic prosthesis designed to be placed in a supraannular position. Five institutions pooled their clinical experiences to evaluate early outcome in patients with this prosthesis.

METHODS: From 1994 to 2000, 639 patients underwent aortic valve replacement with Top Hat (Sulzer Carbomedics) valves at 5 institutions. Mean age was 60 ± 13 years. In this heterogeneous population, 28% of patients had previous cardiac operations and 64% had concomitant procedures, including procedures involving more than 1 heart valve in 32%. Implanted prostheses sizes included the 19 mm (15%), 21 mm (37%), 23 mm (33%), 25 mm (13%), and 27 mm (2%). Mean follow-up was 2.0 ± 1.5 years, and there were 1,206 patient-years of follow-up available for analysis.

RESULTS: Thirty-day mortality was 5.3%. Five-year survival was 74%. Risk factors for death included older age (p = 0.01), decreased ejection fraction (p = 0.007), and increased New York Heart Association functional class (p = 0.003). Five-year freedoms from thromboembolism and hemorrhage were 90% and 85%, respectively. Five-year freedoms from explant and endocarditis were both 99%. There were no structural valve failures.

CONCLUSIONS: The Top Hat valve outcomes have been similar to those of the standard Carbomedics intraannular prostheses. The unique design of the Top Hat valve, with all its components in the aortic sinuses, has particular advantages in the small aortic root, in settings where leaflet entrapment may occur, and in multiple valve replacement.

This article has been cited by other articles:

				J. M. Bernal, J. Lorca, D. Prieto-Salceda, I. Pulitani, A. Ponton, I. Garcia, and J. M. Revuelta Performance at 10 years of the CarboMedics 'Top-Hat' valve. Postclamping time is a predictor of mortality Eur. J. Cardiothorac. Surg., February 1, 2006; 29(2): 144 - 149. [Abstract] [Full Text] [PDF]

				J. Chambers, J. Roxburgh, C. Blauth, J. O'Riordan, F. Hodson, and H. Rimington A randomized comparison of the MCRI On-X and CarboMedics Top Hat bileaflet mechanical replacement aortic valves: Early postoperative hemodynamic function and clinical events J. Thorac. Cardiovasc. Surg., September 1, 2005; 130(3): 759 - 764. [Abstract] [Full Text] [PDF]