home *** CD-ROM | disk | FTP | other *** search
| Unknown | 1992-06-05 | 408.7 KB |
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MacOS 8.1
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Win98
|
DOS
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| Confidence | Program | Detection | Match Type | Support
|
|---|
| 66%
| dexvert
| OS/2 Installation Package (archive/os2InstallPackage)
| ext
| Supported |
| 1%
| dexvert
| BeOS Installation Package (archive/beOSInstallPackage)
| ext
| Unsupported |
| 1%
| dexvert
| Newton Package (archive/newtonPackage)
| ext
| Unsupported |
| 1%
| dexvert
| Independence War 2 mod Package (other/independenceWar2ModPackage)
| ext
| Unsupported |
| 100%
| file
| data
| default
|
|
hex view+--------+-------------------------+-------------------------+--------+--------+
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|00000470| 05 00 ba 14 00 00 38 30 | 00 00 00 01 9f 1a 05 00 |......80|........|
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|00000490| 00 00 38 32 00 00 00 01 | 75 39 05 00 6e 12 00 00 |..82....|u9..n...|
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|000004b0| 00 00 00 01 7a 57 05 00 | 1c 16 00 00 38 35 00 00 |....zW..|....85..|
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|000004d0| e7 7e 05 00 4b 13 00 00 | 38 37 00 00 00 01 32 92 |.~..K...|87....2.|
|000004e0| 05 00 97 0d 00 00 38 38 | 00 00 00 01 c9 9f 05 00 |......88|........|
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|00000500| 00 00 39 30 00 00 00 01 | fa c7 05 00 20 12 00 00 |..90....|.... ...|
|00000510| 39 31 00 00 00 01 1a da | 05 00 6c 0d 00 00 39 32 |91......|..l...92|
|00000520| 00 00 00 01 86 e7 05 00 | 8f 11 00 00 39 33 00 00 |........|....93..|
|00000530| 00 01 15 f9 05 00 4e 0b | 00 00 39 34 00 00 00 01 |......N.|..94....|
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|00000550| 06 00 03 0f 00 00 39 36 | 00 00 00 01 51 25 06 00 |......96|....Q%..|
|00000560| 4a 0f 00 00 39 37 00 00 | 00 01 9b 34 06 00 40 0d |J...97..|...4..@.|
|00000570| 00 00 39 38 00 00 00 01 | db 41 06 00 d3 0e 00 00 |..98....|.A......|
|00000580| 39 39 00 00 00 01 ae 50 | 06 00 31 12 00 00 00 00 |99.....P|..1.....|
|00000590| 00 00 00 00 df 62 06 00 | 00 00 00 00 24 55 6e 69 |.....b..|....$Uni|
|000005a0| 71 75 65 5f 49 44 7b 59 | 52 42 30 32 30 30 30 7d |que_ID{Y|RB02000}|
|000005b0| 0d 0a 24 54 69 74 6c 65 | 7b 54 68 65 20 50 6f 72 |..$Title|{The Por|
|000005c0| 63 69 6e 65 20 42 69 6f | 70 72 6f 73 74 68 65 74 |cine Bio|prosthet|
|000005d0| 69 63 20 48 65 61 72 74 | 20 56 61 6c 76 65 3a 20 |ic Heart| Valve: |
|000005e0| 20 45 78 70 65 72 69 65 | 6e 63 65 20 61 74 20 31 | Experie|nce at 1|
|000005f0| 35 20 59 65 61 72 73 7d | 0d 0a 24 41 75 74 68 6f |5 Years}|..$Autho|
|00000600| 72 7b 0d 0a 4d 61 67 69 | 6c 6c 69 67 61 6e 2c 20 |r{..Magi|lligan, |
|00000610| 44 4a 2c 20 4a 72 0d 0a | 4c 65 77 69 73 2c 20 4a |DJ, Jr..|Lewis, J|
|00000620| 57 2c 20 4a 72 0d 0a 53 | 74 65 69 6e 2c 20 50 0d |W, Jr..S|tein, P.|
|00000630| 0a 41 6c 61 6d 2c 20 4d | 7d 0d 0a 24 41 66 66 69 |.Alam, M|}..$Affi|
|00000640| 6c 69 61 74 69 6f 6e 7b | 48 65 6e 72 79 20 46 6f |liation{|Henry Fo|
|00000650| 72 64 20 48 6f 73 70 2c | 20 44 65 74 72 6f 69 74 |rd Hosp,| Detroit|
|00000660| 7d 0d 0a 24 4a 6f 75 72 | 6e 61 6c 7b 41 6e 6e 20 |}..$Jour|nal{Ann |
|00000670| 54 68 6f 72 61 63 20 53 | 75 72 67 7d 0d 0a 24 56 |Thorac S|urg}..$V|
|00000680| 6f 6c 75 6d 65 7b 34 38 | 7d 0d 0a 24 50 61 67 65 |olume{48|}..$Page|
|00000690| 7b 33 32 34 2d 33 33 30 | 7d 0d 0a 24 44 61 74 65 |{324-330|}..$Date|
|000006a0| 7b 31 39 38 39 7d 0d 0a | 24 59 42 56 6f 6c 7b 31 |{1989}..|$YBVol{1|
|000006b0| 39 39 31 20 59 65 61 72 | 20 42 6f 6f 6b 20 6f 66 |991 Year| Book of|
|000006c0| 20 4d 65 64 69 63 69 6e | 65 7d 0d 0a 24 43 68 61 | Medicin|e}..$Cha|
|000006d0| 70 74 65 72 7b 32 37 2d | 35 7d 0d 0a 24 59 42 45 |pter{27-|5}..$YBE|
|000006e0| 64 69 74 6f 72 7b 44 72 | 73 2e 20 52 6f 67 65 72 |ditor{Dr|s. Roger|
|000006f0| 73 2c 20 44 65 73 20 50 | 72 65 7a 2c 20 43 6c 69 |s, Des P|rez, Cli|
|00000700| 6e 65 2c 20 42 72 61 75 | 6e 77 61 6c 64 2c 20 47 |ne, Brau|nwald, G|
|00000710| 72 65 65 6e 62 65 72 67 | 65 72 2c 20 55 74 69 67 |reenberg|er, Utig|
|00000720| 65 72 2c 0d 0a 45 70 73 | 74 65 69 6e 2c 20 61 6e |er,..Eps|tein, an|
|00000730| 64 20 4d 61 6c 61 77 69 | 73 74 61 7d 0d 0a 24 54 |d Malawi|sta}..$T|
|00000740| 61 62 6c 65 7b 54 61 62 | 6c 65 20 4f 6d 69 74 74 |able{Tab|le Omitt|
|00000750| 65 64 7d 0d 0a 24 43 6f | 6d 6d 65 6e 74 61 74 6f |ed}..$Co|mmentato|
|00000760| 72 7b 45 2e 20 42 72 61 | 75 6e 77 61 6c 64 2c 20 |r{E. Bra|unwald, |
|00000770| 4d 2e 44 2e 7d 0d 0a 0d | 0a 43 6f 70 79 72 69 67 |M.D.}...|.Copyrig|
|00000780| 68 74 20 28 43 29 20 59 | 65 61 72 20 42 6f 6f 6b |ht (C) Y|ear Book|
|00000790| 20 4d 65 64 69 63 61 6c | 20 50 75 62 6c 69 73 68 | Medical| Publish|
|000007a0| 65 72 73 2c 20 49 6e 63 | 2e 20 31 39 39 31 0d 0a |ers, Inc|. 1991..|
|000007b0| 0d 0a 31 39 39 31 20 59 | 65 61 72 20 42 6f 6f 6b |..1991 Y|ear Book|
|000007c0| 20 6f 66 20 4d 65 64 69 | 63 69 6e 65 0d 0a 0d 0a | of Medi|cine....|
|000007d0| 50 61 72 74 20 46 6f 75 | 72 20 2d 2d 20 54 68 65 |Part Fou|r -- The|
|000007e0| 20 48 65 61 72 74 20 61 | 6e 64 20 43 61 72 64 6f | Heart a|nd Cardo|
|000007f0| 76 61 73 63 75 6c 61 72 | 20 44 69 73 65 61 73 65 |vascular| Disease|
|00000800| 0d 0a 0d 0a 43 68 61 70 | 74 65 72 20 32 37 20 2d |....Chap|ter 27 -|
|00000810| 2d 20 56 61 6c 76 75 6c | 61 72 20 48 65 61 72 74 |- Valvul|ar Heart|
|00000820| 20 44 69 73 65 61 73 65 | 0d 0a 0d 0a 2d 2d 2d 2d | Disease|....----|
|00000830| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000840| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000850| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000860| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000870| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 0d 0a 54 68 65 20 |--------|--..The |
|00000880| 50 6f 72 63 69 6e 65 20 | 42 69 6f 70 72 6f 73 74 |Porcine |Bioprost|
|00000890| 68 65 74 69 63 20 48 65 | 61 72 74 20 56 61 6c 76 |hetic He|art Valv|
|000008a0| 65 3a 20 20 45 78 70 65 | 72 69 65 6e 63 65 20 61 |e: Expe|rience a|
|000008b0| 74 20 31 35 20 59 65 61 | 72 73 0d 0a 0d 0a 4d 61 |t 15 Yea|rs....Ma|
|000008c0| 67 69 6c 6c 69 67 61 6e | 20 44 4a 20 4a 72 3b 20 |gilligan| DJ Jr; |
|000008d0| 4c 65 77 69 73 20 4a 57 | 20 4a 72 3b 20 53 74 65 |Lewis JW| Jr; Ste|
|000008e0| 69 6e 20 50 3b 20 41 6c | 61 6d 20 4d 0d 0a 28 48 |in P; Al|am M..(H|
|000008f0| 65 6e 72 79 20 46 6f 72 | 64 20 48 6f 73 70 2c 20 |enry For|d Hosp, |
|00000900| 44 65 74 72 6f 69 74 29 | 0d 0a 41 6e 6e 20 54 68 |Detroit)|..Ann Th|
|00000910| 6f 72 61 63 20 53 75 72 | 67 20 34 38 3a 33 32 34 |orac Sur|g 48:324|
|00000920| 2d 33 33 30 2c 20 31 39 | 38 39 0d 0a 2d 2d 2d 2d |-330, 19|89..----|
|00000930| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000940| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000950| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000960| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000970| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 0d 0a 0d 0a 41 62 |--------|--....Ab|
|00000980| 73 74 72 61 63 74 0d 0a | 0d 0a 20 20 20 20 20 49 |stract..|.. I|
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|000009a0| 6e 74 73 20 73 65 65 6e | 20 73 69 6e 63 65 20 31 |nts seen| since 1|
|000009b0| 39 37 31 20 77 68 6f 20 | 72 65 63 65 69 76 65 64 |971 who |received|
|000009c0| 20 31 2c 30 38 31 20 70 | 6f 72 63 69 6e 65 0d 0a | 1,081 p|orcine..|
|000009d0| 62 69 6f 70 72 6f 73 74 | 68 65 74 69 63 20 76 61 |bioprost|hetic va|
|000009e0| 6c 76 65 73 20 77 65 72 | 65 20 66 6f 6c 6c 6f 77 |lves wer|e follow|
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|00000a10| 20 61 67 65 20 61 74 0d | 0a 6f 70 65 72 61 74 69 | age at.|.operati|
|00000a20| 6f 6e 20 77 61 73 20 35 | 35 20 79 65 61 72 73 20 |on was 5|5 years |
|00000a30| 61 6e 64 20 74 68 65 20 | 6d 65 61 6e 20 6c 65 6e |and the |mean len|
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|00000a50| 20 77 61 73 20 6e 65 61 | 72 6c 79 20 36 20 79 65 | was nea|rly 6 ye|
|00000a60| 61 72 73 2e 0d 0a 20 20 | 20 20 20 50 61 74 69 65 |ars... | Patie|
|00000a70| 6e 74 20 73 75 72 76 69 | 76 61 6c 2c 20 69 6e 63 |nt survi|val, inc|
|00000a80| 6c 75 64 69 6e 67 20 6f | 70 65 72 61 74 69 76 65 |luding o|perative|
|00000a90| 20 64 65 61 74 68 73 2c | 20 77 61 73 20 38 30 25 | deaths,| was 80%|
|00000aa0| 20 61 74 20 35 20 79 65 | 61 72 73 2c 20 35 39 25 | at 5 ye|ars, 59%|
|00000ab0| 20 61 74 0d 0a 31 30 20 | 79 65 61 72 73 2c 20 61 | at..10 |years, a|
|00000ac0| 6e 64 20 33 38 25 20 61 | 74 20 31 35 20 79 65 61 |nd 38% a|t 15 yea|
|00000ad0| 72 73 2e 20 20 54 68 65 | 20 72 65 73 70 65 63 74 |rs. The| respect|
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|00000b00| 62 6f 65 6d 62 6f 6c 69 | 73 6d 20 77 65 72 65 20 |boemboli|sm were |
|00000b10| 39 36 25 2c 20 39 32 25 | 2c 20 61 6e 64 20 38 39 |96%, 92%|, and 89|
|00000b20| 25 2e 20 20 54 68 65 72 | 65 20 77 65 72 65 20 35 |%. Ther|e were 5|
|00000b30| 36 20 65 70 69 73 6f 64 | 65 73 20 6f 66 20 70 72 |6 episod|es of pr|
|00000b40| 6f 73 74 68 65 74 69 63 | 0d 0a 76 61 6c 76 65 20 |osthetic|..valve |
|00000b50| 65 6e 64 6f 63 61 72 64 | 69 74 69 73 2c 20 66 61 |endocard|itis, fa|
|00000b60| 69 72 6c 79 20 65 76 65 | 6e 6c 79 20 64 69 73 74 |irly eve|nly dist|
|00000b70| 72 69 62 75 74 65 64 20 | 6f 76 65 72 20 74 68 65 |ributed |over the|
|00000b80| 20 66 6f 6c 6c 6f 77 2d | 75 70 20 70 65 72 69 6f | follow-|up perio|
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|00000bc0| 65 72 61 74 69 6f 6e 20 | 77 65 72 65 20 39 38 25 |eration |were 98%|
|00000bd0| 20 61 74 20 35 20 79 65 | 61 72 73 2c 20 37 31 25 | at 5 ye|ars, 71%|
|00000be0| 0d 0a 61 74 20 31 30 20 | 79 65 61 72 73 2c 20 61 |..at 10 |years, a|
|00000bf0| 6e 64 20 33 31 25 20 61 | 74 20 31 35 20 79 65 61 |nd 31% a|t 15 yea|
|00000c00| 72 73 20 28 46 69 67 20 | 32 37 2d 31 29 2e 20 20 |rs (Fig |27-1). |
|00000c10| 44 65 67 65 6e 65 72 61 | 74 69 6f 6e 20 77 61 73 |Degenera|tion was|
|00000c20| 20 72 65 6c 61 74 65 64 | 20 74 6f 20 61 67 65 0d | related| to age.|
|00000c30| 0a 79 6f 75 6e 67 65 72 | 20 74 68 61 6e 20 33 35 |.younger| than 35|
|00000c40| 20 79 65 61 72 73 20 61 | 74 20 73 75 72 67 65 72 | years a|t surger|
|00000c50| 79 2c 20 66 65 6d 61 6c | 65 20 73 65 78 2c 20 61 |y, femal|e sex, a|
|00000c60| 6e 64 20 61 20 63 61 72 | 64 69 61 63 20 69 6e 64 |nd a car|diac ind|
|00000c70| 65 78 20 67 72 65 61 74 | 65 72 20 74 68 61 6e 0d |ex great|er than.|
|00000c80| 0a 32 20 4c 2f 6d 69 6e | 2f 6d 5e 32 2e 20 20 52 |.2 L/min|/m^2. R|
|00000c90| 65 6f 70 65 72 61 74 69 | 6f 6e 20 77 61 73 20 64 |eoperati|on was d|
|00000ca0| 6f 6e 65 20 31 36 35 20 | 74 69 6d 65 73 20 66 6f |one 165 |times fo|
|00000cb0| 72 20 61 20 66 69 72 73 | 74 20 76 61 6c 76 65 20 |r a firs|t valve |
|00000cc0| 66 61 69 6c 75 72 65 2c | 20 61 6e 64 20 31 31 0d |failure,| and 11.|
|00000cd0| 0a 70 61 74 69 65 6e 74 | 73 20 68 61 64 20 72 65 |.patient|s had re|
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|00000d00| 6c 75 72 65 2e 20 20 4f | 76 65 72 61 6c 6c 20 6d |lure. O|verall m|
|00000d10| 6f 72 74 61 6c 69 74 79 | 20 66 6f 72 0d 0a 72 65 |ortality| for..re|
|00000d20| 6f 70 65 72 61 74 69 6f | 6e 20 6e 65 63 65 73 73 |operatio|n necess|
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|00000d60| 25 2e 0d 0a 20 20 20 20 | 20 45 78 70 65 72 69 65 |%... | Experie|
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|00000d80| 20 74 68 65 20 70 6f 72 | 63 69 6e 65 20 62 69 6f | the por|cine bio|
|00000d90| 70 72 6f 73 74 68 65 74 | 69 63 20 76 61 6c 76 65 |prosthet|ic valve|
|00000da0| 20 73 75 67 67 65 73 74 | 73 20 74 68 61 74 20 69 | suggest|s that i|
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|00000df0| 63 61 74 69 6f 6e 73 20 | 74 6f 0d 0a 61 6e 74 69 |cations |to..anti|
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|00000e50| 73 6d 2c 20 62 75 74 20 | 72 61 74 65 73 20 6f 66 |sm, but |rates of|
|00000e60| 20 73 74 72 75 63 74 75 | 72 61 6c 20 76 61 6c 76 | structu|ral valv|
|00000e70| 65 20 64 65 67 65 6e 65 | 72 61 74 69 6f 6e 20 61 |e degene|ration a|
|00000e80| 72 65 20 73 69 67 6e 69 | 66 69 63 61 6e 74 2e 0d |re signi|ficant..|
|00000e90| 0a 0d 0a 50 6f 73 74 2d | 43 6f 6d 6d 65 6e 74 0d |...Post-|Comment.|
|00000ea0| 0a 0d 0a 20 20 20 20 20 | 54 68 65 20 63 6f 6d 6d |... |The comm|
|00000eb0| 65 72 63 69 61 6c 6c 79 | 20 70 72 65 70 61 72 65 |ercially| prepare|
|00000ec0| 64 20 70 6f 72 63 69 6e | 65 20 62 69 6f 70 72 6f |d porcin|e biopro|
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|00000ef0| 0d 0a 43 61 72 70 65 6e | 74 69 65 72 2d 45 64 77 |..Carpen|tier-Edw|
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|00000f20| 31 39 37 30 2c 20 61 6e | 64 20 69 74 20 69 73 20 |1970, an|d it is |
|00000f30| 6e 6f 77 20 61 70 70 72 | 6f 70 72 69 61 74 65 0d |now appr|opriate.|
|00000f40| 0a 74 6f 20 74 61 6b 65 | 20 61 20 6c 6f 6f 6b 20 |.to take| a look |
|00000f50| 61 74 20 74 68 65 20 6c | 6f 6e 67 2d 74 65 72 6d |at the l|ong-term|
|00000f60| 20 6f 75 74 63 6f 6d 65 | 2e 20 20 54 68 65 20 72 | outcome|. The r|
|00000f70| 65 73 75 6c 74 73 20 6f | 66 20 74 68 65 20 70 61 |esults o|f the pa|
|00000f80| 70 65 72 20 61 62 73 74 | 72 61 63 74 65 64 0d 0a |per abst|racted..|
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|00000fa0| 20 6d 75 63 68 20 69 6e | 20 6c 69 6e 65 20 77 69 | much in| line wi|
|00000fb0| 74 68 20 74 68 6f 73 65 | 20 6f 66 20 6f 74 68 65 |th those| of othe|
|00000fc0| 72 20 6c 61 72 67 65 20 | 73 65 72 69 65 73 2e 20 |r large |series. |
|00000fd0| 20 46 6f 72 20 65 78 61 | 6d 70 6c 65 2c 0d 0a 4a | For exa|mple,..J|
|00000fe0| 61 6d 69 65 73 6f 6e 20 | 65 74 20 61 6c 2e 20 28 |amieson |et al. (|
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|00001010| 63 65 69 76 69 6e 67 20 | 31 2c 33 30 33 20 76 61 |ceiving |1,303 va|
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|00001030| 61 72 79 20 31 39 37 35 | 2e 20 20 54 68 65 20 74 |ary 1975|. The t|
|00001040| 68 72 6f 6d 62 6f 65 6d | 62 6f 6c 69 63 20 72 61 |hromboem|bolic ra|
|00001050| 74 65 20 77 61 73 20 31 | 2e 35 25 20 70 65 72 20 |te was 1|.5% per |
|00001060| 70 61 74 69 65 6e 74 20 | 79 65 61 72 2e 20 20 53 |patient |year. S|
|00001070| 74 72 75 63 74 75 72 61 | 6c 0d 0a 64 65 74 65 72 |tructura|l..deter|
|00001080| 69 6f 72 61 74 69 6f 6e | 20 68 61 64 20 6f 63 63 |ioration| had occ|
|00001090| 75 72 72 65 64 20 69 6e | 20 32 31 25 20 6f 66 20 |urred in| 21% of |
|000010a0| 74 68 65 20 61 6f 72 74 | 69 63 20 76 61 6c 76 65 |the aort|ic valve|
|000010b0| 73 20 61 6e 64 20 32 38 | 25 20 6f 66 20 74 68 65 |s and 28|% of the|
|000010c0| 20 6d 69 74 72 61 6c 0d | 0a 76 61 6c 76 65 73 20 | mitral.|.valves |
|000010d0| 62 79 20 31 30 20 79 65 | 61 72 73 2e 20 20 41 74 |by 10 ye|ars. At|
|000010e0| 20 31 30 20 79 65 61 72 | 73 2c 20 35 39 25 20 6f | 10 year|s, 59% o|
|000010f0| 66 20 74 68 65 20 70 61 | 74 69 65 6e 74 73 20 68 |f the pa|tients h|
|00001100| 61 64 20 65 78 70 65 72 | 69 65 6e 63 65 64 20 6e |ad exper|ienced n|
|00001110| 6f 0d 0a 76 61 6c 76 65 | 2d 72 65 6c 61 74 65 64 |o..valve|-related|
|00001120| 20 6d 6f 72 74 61 6c 69 | 74 79 20 6f 72 20 72 65 | mortali|ty or re|
|00001130| 73 69 64 75 61 6c 20 6d | 6f 72 62 69 64 69 74 79 |sidual m|orbidity|
|00001140| 2c 20 6f 72 20 72 65 71 | 75 69 72 65 64 20 72 65 |, or req|uired re|
|00001150| 6f 70 65 72 61 74 69 6f | 6e 2e 20 20 4a 6f 6e 65 |operatio|n. Jone|
|00001160| 73 0d 0a 65 74 20 61 6c | 2e 20 28 32 29 20 72 65 |s..et al|. (2) re|
|00001170| 70 6f 72 74 65 64 20 6f | 6e 20 31 2c 30 35 30 20 |ported o|n 1,050 |
|00001180| 70 6f 72 63 69 6e 65 20 | 62 69 6f 70 72 6f 73 74 |porcine |bioprost|
|00001190| 68 65 74 69 63 20 76 61 | 6c 76 65 20 72 65 70 6c |hetic va|lve repl|
|000011a0| 61 63 65 6d 65 6e 74 73 | 2e 20 20 41 74 20 31 30 |acements|. At 10|
|000011b0| 0d 0a 79 65 61 72 73 20 | 74 68 65 20 66 72 65 65 |..years |the free|
|000011c0| 64 6f 6d 20 66 72 6f 6d | 20 73 74 72 75 63 74 75 |dom from| structu|
|000011d0| 72 61 6c 20 76 61 6c 76 | 65 20 64 65 67 65 6e 65 |ral valv|e degene|
|000011e0| 72 61 74 69 6f 6e 20 77 | 61 73 20 62 65 74 74 65 |ration w|as bette|
|000011f0| 72 20 69 6e 20 74 68 65 | 20 61 6f 72 74 69 63 0d |r in the| aortic.|
|00001200| 0a 74 68 61 6e 20 69 6e | 20 74 68 65 20 6d 69 74 |.than in| the mit|
|00001210| 72 61 6c 20 67 72 6f 75 | 70 2d 2d 37 39 25 20 76 |ral grou|p--79% v|
|00001220| 73 2e 20 36 33 25 2e 20 | 20 54 68 65 20 61 75 74 |s. 63%. | The aut|
|00001230| 68 6f 72 73 20 63 6f 6e | 73 69 64 65 72 20 74 68 |hors con|sider th|
|00001240| 65 20 70 6f 72 63 69 6e | 65 0d 0a 62 69 6f 73 79 |e porcin|e..biosy|
|00001250| 6e 74 68 65 74 69 63 20 | 76 61 6c 76 65 20 74 6f |nthetic |valve to|
|00001260| 20 62 65 20 74 68 65 20 | 76 61 6c 76 65 20 6f 66 | be the |valve of|
|00001270| 20 63 68 6f 69 63 65 20 | 6f 6e 6c 79 20 66 6f 72 | choice |only for|
|00001280| 20 70 61 74 69 65 6e 74 | 73 20 36 30 20 79 65 61 | patient|s 60 yea|
|00001290| 72 73 20 6f 72 0d 0a 6f | 6c 64 65 72 2e 20 20 41 |rs or..o|lder. A|
|000012a0| 73 20 53 74 61 72 72 20 | 28 33 29 20 68 61 73 20 |s Starr |(3) has |
|000012b0| 70 6f 69 6e 74 65 64 20 | 6f 75 74 2c 20 6f 6c 64 |pointed |out, old|
|000012c0| 20 61 67 65 20 6d 61 79 | 20 70 72 6f 74 65 63 74 | age may| protect|
|000012d0| 20 66 72 6f 6d 20 73 74 | 72 75 63 74 75 72 61 6c | from st|ructural|
|000012e0| 0d 0a 66 61 69 6c 75 72 | 65 2e 20 20 50 6f 72 63 |..failur|e. Porc|
|000012f0| 69 6e 65 20 62 69 6f 70 | 72 6f 73 74 68 65 74 69 |ine biop|rostheti|
|00001300| 63 20 76 61 6c 76 65 73 | 20 74 68 61 74 20 62 65 |c valves| that be|
|00001310| 63 6f 6d 65 20 73 74 65 | 6e 6f 74 69 63 20 63 61 |come ste|notic ca|
|00001320| 6e 20 62 65 20 74 72 65 | 61 74 65 64 0d 0a 73 75 |n be tre|ated..su|
|00001330| 63 63 65 73 73 66 75 6c | 6c 79 20 77 69 74 68 20 |ccessful|ly with |
|00001340| 64 6f 75 62 6c 65 2d 62 | 61 6c 6c 6f 6f 6e 20 76 |double-b|alloon v|
|00001350| 61 6c 76 75 6c 6f 70 6c | 61 73 74 79 20 28 34 29 |alvulopl|asty (4)|
|00001360| 2e 2d 2d 45 2e 20 42 72 | 61 75 6e 77 61 6c 64 2c |.--E. Br|aunwald,|
|00001370| 20 4d 2e 44 2e 0d 0a 24 | 55 6e 69 71 75 65 5f 49 | M.D...$|Unique_I|
|00001380| 44 7b 59 52 42 30 32 30 | 30 31 7d 0d 0a 24 54 69 |D{YRB020|01}..$Ti|
|00001390| 74 6c 65 7b 54 65 6e 2d | 59 65 61 72 20 45 78 70 |tle{Ten-|Year Exp|
|000013a0| 65 72 69 65 6e 63 65 20 | 57 69 74 68 20 74 68 65 |erience |With the|
|000013b0| 20 4d 65 64 74 72 6f 6e | 69 63 20 48 61 6c 6c 20 | Medtron|ic Hall |
|000013c0| 56 61 6c 76 75 6c 61 72 | 20 50 72 6f 73 74 68 65 |Valvular| Prosthe|
|000013d0| 73 69 73 3a 20 20 41 0d | 0a 53 74 75 64 79 20 6f |sis: A.|.Study o|
|000013e0| 66 20 31 2c 31 30 34 20 | 50 61 74 69 65 6e 74 73 |f 1,104 |Patients|
|000013f0| 7d 0d 0a 24 41 75 74 68 | 6f 72 7b 0d 0a 4e 69 74 |}..$Auth|or{..Nit|
|00001400| 74 65 72 2d 48 61 75 67 | 65 2c 20 53 0d 0a 41 62 |ter-Haug|e, S..Ab|
|00001410| 64 65 6c 6e 6f 6f 72 2c | 20 4d 7d 0d 0a 24 41 66 |delnoor,| M}..$Af|
|00001420| 66 69 6c 69 61 74 69 6f | 6e 7b 55 6e 69 76 20 6f |filiatio|n{Univ o|
|00001430| 66 20 4f 73 6c 6f 7d 0d | 0a 24 4a 6f 75 72 6e 61 |f Oslo}.|.$Journa|
|00001440| 6c 7b 43 69 72 63 75 6c | 61 74 69 6f 6e 7d 0d 0a |l{Circul|ation}..|
|00001450| 24 56 6f 6c 75 6d 65 7b | 38 30 28 53 75 70 70 6c |$Volume{|80(Suppl|
|00001460| 20 49 29 7d 0d 0a 24 50 | 61 67 65 7b 31 34 33 2d | I)}..$P|age{143-|
|00001470| 31 34 38 7d 0d 0a 24 44 | 61 74 65 7b 31 39 38 39 |148}..$D|ate{1989|
|00001480| 7d 0d 0a 24 59 42 56 6f | 6c 7b 31 39 39 31 20 59 |}..$YBVo|l{1991 Y|
|00001490| 65 61 72 20 42 6f 6f 6b | 20 6f 66 20 4d 65 64 69 |ear Book| of Medi|
|000014a0| 63 69 6e 65 7d 0d 0a 24 | 43 68 61 70 74 65 72 7b |cine}..$|Chapter{|
|000014b0| 32 37 2d 36 7d 0d 0a 24 | 59 42 45 64 69 74 6f 72 |27-6}..$|YBEditor|
|000014c0| 7b 44 72 73 2e 20 52 6f | 67 65 72 73 2c 20 44 65 |{Drs. Ro|gers, De|
|000014d0| 73 20 50 72 65 7a 2c 20 | 43 6c 69 6e 65 2c 20 42 |s Prez, |Cline, B|
|000014e0| 72 61 75 6e 77 61 6c 64 | 2c 20 47 72 65 65 6e 62 |raunwald|, Greenb|
|000014f0| 65 72 67 65 72 2c 20 55 | 74 69 67 65 72 2c 0d 0a |erger, U|tiger,..|
|00001500| 45 70 73 74 65 69 6e 2c | 20 61 6e 64 20 4d 61 6c |Epstein,| and Mal|
|00001510| 61 77 69 73 74 61 7d 0d | 0a 24 54 61 62 6c 65 7b |awista}.|.$Table{|
|00001520| 7d 0d 0a 24 43 6f 6d 6d | 65 6e 74 61 74 6f 72 7b |}..$Comm|entator{|
|00001530| 45 2e 20 42 72 61 75 6e | 77 61 6c 64 2c 20 4d 2e |E. Braun|wald, M.|
|00001540| 44 2e 7d 0d 0a 0d 0a 43 | 6f 70 79 72 69 67 68 74 |D.}....C|opyright|
|00001550| 20 28 43 29 20 59 65 61 | 72 20 42 6f 6f 6b 20 4d | (C) Yea|r Book M|
|00001560| 65 64 69 63 61 6c 20 50 | 75 62 6c 69 73 68 65 72 |edical P|ublisher|
|00001570| 73 2c 20 49 6e 63 2e 20 | 31 39 39 31 0d 0a 0d 0a |s, Inc. |1991....|
|00001580| 31 39 39 31 20 59 65 61 | 72 20 42 6f 6f 6b 20 6f |1991 Yea|r Book o|
|00001590| 66 20 4d 65 64 69 63 69 | 6e 65 0d 0a 0d 0a 50 61 |f Medici|ne....Pa|
|000015a0| 72 74 20 46 6f 75 72 20 | 2d 2d 20 54 68 65 20 48 |rt Four |-- The H|
|000015b0| 65 61 72 74 20 61 6e 64 | 20 43 61 72 64 6f 76 61 |eart and| Cardova|
|000015c0| 73 63 75 6c 61 72 20 44 | 69 73 65 61 73 65 0d 0a |scular D|isease..|
|000015d0| 0d 0a 43 68 61 70 74 65 | 72 20 32 37 20 2d 2d 20 |..Chapte|r 27 -- |
|000015e0| 56 61 6c 76 75 6c 61 72 | 20 48 65 61 72 74 20 44 |Valvular| Heart D|
|000015f0| 69 73 65 61 73 65 0d 0a | 0d 0a 2d 2d 2d 2d 2d 2d |isease..|..------|
|00001600| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001610| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001620| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001630| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001640| 2d 2d 2d 2d 2d 2d 2d 2d | 0d 0a 54 65 6e 2d 59 65 |--------|..Ten-Ye|
|00001650| 61 72 20 45 78 70 65 72 | 69 65 6e 63 65 20 57 69 |ar Exper|ience Wi|
|00001660| 74 68 20 74 68 65 20 4d | 65 64 74 72 6f 6e 69 63 |th the M|edtronic|
|00001670| 20 48 61 6c 6c 20 56 61 | 6c 76 75 6c 61 72 20 50 | Hall Va|lvular P|
|00001680| 72 6f 73 74 68 65 73 69 | 73 3a 20 20 41 20 53 74 |rosthesi|s: A St|
|00001690| 75 64 79 20 6f 66 0d 0a | 31 2c 31 30 34 20 50 61 |udy of..|1,104 Pa|
|000016a0| 74 69 65 6e 74 73 0d 0a | 0d 0a 4e 69 74 74 65 72 |tients..|..Nitter|
|000016b0| 2d 48 61 75 67 65 20 53 | 3b 20 41 62 64 65 6c 6e |-Hauge S|; Abdeln|
|000016c0| 6f 6f 72 20 4d 0d 0a 28 | 55 6e 69 76 20 6f 66 20 |oor M..(|Univ of |
|000016d0| 4f 73 6c 6f 29 0d 0a 43 | 69 72 63 75 6c 61 74 69 |Oslo)..C|irculati|
|000016e0| 6f 6e 20 38 30 28 53 75 | 70 70 6c 20 49 29 3a 31 |on 80(Su|ppl I):1|
|000016f0| 34 33 2d 31 34 38 2c 20 | 31 39 38 39 0d 0a 2d 2d |43-148, |1989..--|
|00001700| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001710| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001720| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001730| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001740| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 0d 0a 0d 0a |--------|----....|
|00001750| 41 62 73 74 72 61 63 74 | 0d 0a 0d 0a 20 20 20 20 |Abstract|.... |
|00001760| 20 53 69 6e 63 65 20 31 | 39 37 37 2c 20 77 68 65 | Since 1|977, whe|
|00001770| 6e 20 74 68 65 20 4d 65 | 64 74 72 6f 6e 69 63 20 |n the Me|dtronic |
|00001780| 48 61 6c 6c 20 76 61 6c | 76 75 6c 61 72 20 70 72 |Hall val|vular pr|
|00001790| 6f 73 74 68 65 73 69 73 | 2c 20 61 20 74 69 6c 74 |osthesis|, a tilt|
|000017a0| 69 6e 67 2d 64 69 73 6b | 0d 0a 76 61 6c 76 65 2c |ing-disk|..valve,|
|000017b0| 20 77 61 73 20 69 6e 74 | 72 6f 64 75 63 65 64 2c | was int|roduced,|
|000017c0| 20 69 74 20 68 61 73 20 | 62 65 65 6e 20 74 68 65 | it has |been the|
|000017d0| 20 73 74 61 6e 64 61 72 | 64 20 72 65 70 6c 61 63 | standar|d replac|
|000017e0| 65 6d 65 6e 74 20 76 61 | 6c 76 65 20 61 74 20 74 |ement va|lve at t|
|000017f0| 68 65 0d 0a 55 6e 69 76 | 65 72 73 69 74 79 20 6f |he..Univ|ersity o|
|00001800| 66 20 4f 73 6c 6f 2e 20 | 20 41 20 72 65 76 69 65 |f Oslo. | A revie|
|00001810| 77 20 77 61 73 20 6d 61 | 64 65 20 6f 66 20 6c 6f |w was ma|de of lo|
|00001820| 6e 67 2d 74 65 72 6d 20 | 65 78 70 65 72 69 65 6e |ng-term |experien|
|00001830| 63 65 20 77 69 74 68 20 | 74 68 65 20 76 61 6c 76 |ce with |the valv|
|00001840| 65 0d 0a 69 6e 20 31 2c | 31 30 34 20 63 6f 6e 73 |e..in 1,|104 cons|
|00001850| 65 63 75 74 69 76 65 20 | 70 61 74 69 65 6e 74 73 |ecutive |patients|
|00001860| 2e 20 20 46 72 6f 6d 20 | 4a 75 6e 65 20 31 39 37 |. From |June 197|
|00001870| 37 20 74 68 72 6f 75 67 | 68 20 41 75 67 75 73 74 |7 throug|h August|
|00001880| 20 31 39 38 37 2c 20 74 | 68 65 72 65 20 77 65 72 | 1987, t|here wer|
|00001890| 65 0d 0a 38 31 36 20 61 | 6f 72 74 69 63 20 28 41 |e..816 a|ortic (A|
|000018a0| 56 52 29 2c 20 31 38 37 | 20 6d 69 74 72 61 6c 20 |VR), 187| mitral |
|000018b0| 28 4d 56 52 29 2c 20 61 | 6e 64 20 31 30 31 20 64 |(MVR), a|nd 101 d|
|000018c0| 6f 75 62 6c 65 2d 20 28 | 44 56 52 29 20 28 61 6f |ouble- (|DVR) (ao|
|000018d0| 72 74 69 63 20 61 6e 64 | 20 6d 69 74 72 61 6c 29 |rtic and| mitral)|
|000018e0| 0d 0a 76 61 6c 76 65 20 | 72 65 70 6c 61 63 65 6d |..valve |replacem|
|000018f0| 65 6e 74 73 2e 20 20 46 | 6f 6c 6c 6f 77 2d 75 70 |ents. F|ollow-up|
|00001900| 20 77 61 73 20 31 30 30 | 25 20 20 63 6f 6d 70 6c | was 100|% compl|
|00001910| 65 74 65 2e 20 20 41 6c | 6c 20 70 61 74 69 65 6e |ete. Al|l patien|
|00001920| 74 73 20 77 65 72 65 0d | 0a 72 65 61 64 6d 69 74 |ts were.|.readmit|
|00001930| 74 65 64 20 74 6f 20 74 | 68 65 20 68 6f 73 70 69 |ted to t|he hospi|
|00001940| 74 61 6c 20 61 74 20 6c | 65 61 73 74 20 6f 6e 63 |tal at l|east onc|
|00001950| 65 20 64 75 72 69 6e 67 | 20 74 68 65 20 66 69 72 |e during| the fir|
|00001960| 73 74 20 70 6f 73 74 6f | 70 65 72 61 74 69 76 65 |st posto|perative|
|00001970| 20 79 65 61 72 0d 0a 61 | 6e 64 20 73 65 6e 74 20 | year..a|nd sent |
|00001980| 61 20 64 65 74 61 69 6c | 65 64 20 71 75 65 73 74 |a detail|ed quest|
|00001990| 69 6f 6e 6e 61 69 72 65 | 20 65 76 65 72 79 20 31 |ionnaire| every 1|
|000019a0| 32 20 6d 6f 6e 74 68 73 | 2e 20 20 57 61 72 66 61 |2 months|. Warfa|
|000019b0| 72 69 6e 20 74 61 62 6c | 65 74 73 20 77 65 72 65 |rin tabl|ets were|
|000019c0| 0d 0a 67 69 76 65 6e 20 | 66 6f 72 20 6c 69 66 65 |..given |for life|
|000019d0| 2d 6c 6f 6e 67 20 61 6e | 74 69 63 6f 61 67 75 6c |-long an|ticoagul|
|000019e0| 61 74 69 6f 6e 20 74 72 | 65 61 74 6d 65 6e 74 2e |ation tr|eatment.|
|000019f0| 0d 0a 20 20 20 20 20 45 | 61 72 6c 79 20 64 65 61 |.. E|arly dea|
|00001a00| 74 68 73 2c 20 77 69 74 | 68 69 6e 20 33 30 20 64 |ths, wit|hin 30 d|
|00001a10| 61 79 73 20 70 6f 73 74 | 6f 70 65 72 61 74 69 76 |ays post|operativ|
|00001a20| 65 6c 79 2c 20 6f 63 63 | 75 72 72 65 64 20 69 6e |ely, occ|urred in|
|00001a30| 20 35 35 20 63 61 73 65 | 73 20 28 35 25 29 2e 0d | 55 case|s (5%)..|
|00001a40| 0a 4d 6f 73 74 20 28 39 | 30 25 29 20 6f 66 20 74 |.Most (9|0%) of t|
|00001a50| 68 65 20 65 61 72 6c 79 | 20 64 65 61 74 68 73 20 |he early| deaths |
|00001a60| 72 65 73 75 6c 74 65 64 | 20 66 72 6f 6d 20 63 6f |resulted| from co|
|00001a70| 6e 67 65 73 74 69 76 65 | 20 68 65 61 72 74 20 66 |ngestive| heart f|
|00001a80| 61 69 6c 75 72 65 2c 0d | 0a 61 72 72 68 79 74 68 |ailure,.|.arrhyth|
|00001a90| 6d 69 61 73 2c 20 61 6e | 64 20 6d 75 6c 74 69 70 |mias, an|d multip|
|00001aa0| 6c 65 20 6f 72 67 61 6e | 20 66 61 69 6c 75 72 65 |le organ| failure|
|00001ab0| 2e 20 20 45 61 72 6c 79 | 20 6d 6f 72 74 61 6c 69 |. Early| mortali|
|00001ac0| 74 79 20 77 61 73 20 68 | 69 67 68 65 73 74 20 28 |ty was h|ighest (|
|00001ad0| 31 30 25 29 20 69 6e 0d | 0a 74 68 65 20 44 56 52 |10%) in.|.the DVR|
|00001ae0| 20 67 72 6f 75 70 20 61 | 6e 64 20 6c 6f 77 65 73 | group a|nd lowes|
|00001af0| 74 20 28 33 2e 38 25 29 | 20 69 6e 20 74 68 65 20 |t (3.8%)| in the |
|00001b00| 41 56 52 20 67 72 6f 75 | 70 3b 20 44 56 52 20 77 |AVR grou|p; DVR w|
|00001b10| 61 73 20 61 6c 73 6f 20 | 61 73 73 6f 63 69 61 74 |as also |associat|
|00001b20| 65 64 20 77 69 74 68 0d | 0a 61 20 73 69 67 6e 69 |ed with.|.a signi|
|00001b30| 66 69 63 61 6e 74 6c 79 | 20 68 69 67 68 65 72 20 |ficantly| higher |
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|00002930| 0a 43 72 61 77 66 6f 72 | 64 20 4d 48 3b 20 53 6f |.Crawfor|d MH; So|
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|00002a10| 41 6c 62 75 71 75 65 72 | 71 75 65 3b 20 48 69 6e |Albuquer|que; Hin|
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|00002ac0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002ad0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002ae0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002af0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
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|00002dc0| 0d 0a 76 6f 6c 75 6d 65 | 2e 0d 0a 20 20 20 20 20 |..volume|... |
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|00003150| 63 74 69 6f 6e 2e 20 20 | 49 6e 20 74 68 6f 73 65 |ction. |In those|
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|00003190| 20 70 72 65 73 73 75 72 | 65 20 6f 66 20 3c 3d 32 | pressur|e of <=2|
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|00003200| 20 76 6f 6c 75 6d 65 20 | 69 6e 64 65 78 20 28 45 | volume |index (E|
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|00003290| 20 20 20 20 20 42 65 63 | 61 75 73 65 20 6e 6f 20 | Bec|ause no |
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|00003310| 77 69 74 68 20 4d 53 2c | 20 76 61 6c 76 65 0d 0a |with MS,| valve..|
|00003320| 72 65 70 6c 61 63 65 6d | 65 6e 74 20 61 6e 64 20 |replacem|ent and |
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|00003350| 62 61 73 69 73 20 6f 66 | 20 73 79 6d 70 74 6f 6d |basis of| symptom|
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|000033c0| 20 73 75 72 67 65 72 79 | 20 69 73 20 70 65 72 66 | surgery| is perf|
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|00003420| 74 68 65 20 45 53 56 49 | 20 69 6e 63 72 65 61 73 |the ESVI| increas|
|00003430| 65 73 20 74 6f 20 6d 6f | 72 65 20 74 68 61 6e 20 |es to mo|re than |
|00003440| 35 30 20 6d 4c 2f 6d 5e | 32 2c 20 6f 72 0d 0a 70 |50 mL/m^|2, or..p|
|00003450| 75 6c 6d 6f 6e 61 72 79 | 20 68 79 70 65 72 74 65 |ulmonary| hyperte|
|00003460| 6e 73 69 6f 6e 20 64 65 | 76 65 6c 6f 70 73 2e 0d |nsion de|velops..|
|00003470| 0a 0d 0a 50 6f 73 74 2d | 43 6f 6d 6d 65 6e 74 0d |...Post-|Comment.|
|00003480| 0a 0d 0a 20 20 20 20 20 | 49 74 20 68 61 73 20 62 |... |It has b|
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|000034a0| 72 20 73 6f 6d 65 20 74 | 69 6d 65 20 74 68 61 74 |r some t|ime that|
|000034b0| 20 6f 70 65 72 61 74 69 | 76 65 20 72 65 70 6c 61 | operati|ve repla|
|000034c0| 63 65 6d 65 6e 74 20 6f | 66 20 74 68 65 0d 0a 6d |cement o|f the..m|
|000034d0| 69 74 72 61 6c 20 76 61 | 6c 76 65 2c 20 72 65 67 |itral va|lve, reg|
|000034e0| 61 72 64 6c 65 73 73 20 | 6f 66 20 74 68 65 20 73 |ardless |of the s|
|000034f0| 70 65 63 69 66 69 63 20 | 70 72 6f 73 74 68 65 73 |pecific |prosthes|
|00003500| 69 73 20 75 73 65 64 2c | 20 6d 61 79 20 6c 65 61 |is used,| may lea|
|00003510| 76 65 20 74 68 65 0d 0a | 70 61 74 69 65 6e 74 20 |ve the..|patient |
|00003520| 77 69 74 68 20 69 6d 70 | 61 69 72 65 64 20 6c 65 |with imp|aired le|
|00003530| 66 74 20 76 65 6e 74 72 | 69 63 75 6c 61 72 20 66 |ft ventr|icular f|
|00003540| 75 6e 63 74 69 6f 6e 20 | 62 65 63 61 75 73 65 20 |unction |because |
|00003550| 74 68 65 20 73 75 62 76 | 61 6c 76 75 6c 61 72 0d |the subv|alvular.|
|00003560| 0a 61 70 70 61 72 61 74 | 75 73 20 28 70 61 70 69 |.apparat|us (papi|
|00003570| 6c 6c 61 72 79 20 6d 75 | 73 63 6c 65 73 2c 20 63 |llary mu|scles, c|
|00003580| 68 6f 72 64 61 65 20 74 | 65 6e 64 69 6e 61 65 29 |hordae t|endinae)|
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|00003630| 20 73 65 76 65 72 65 20 | 4d 52 20 28 77 69 74 68 | severe |MR (with|
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|00003670| 61 74 20 69 6e 74 65 72 | 76 61 6c 73 20 6f 66 20 |at inter|vals of |
|00003680| 70 65 72 68 61 70 73 20 | 36 20 6d 6f 6e 74 68 73 |perhaps |6 months|
|00003690| 20 62 79 0d 0a 6d 65 61 | 6e 73 20 6f 66 20 72 61 | by..mea|ns of ra|
|000036a0| 64 69 6f 6e 75 63 6c 69 | 64 65 20 61 6e 67 69 6f |dionucli|de angio|
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|00003f00| 45 2e 20 42 72 61 75 6e | 77 61 6c 64 2c 20 4d 2e |E. Braun|wald, M.|
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|00004180| 69 6c 75 72 65 0d 0a 0d | 0a 2d 2d 2d 2d 2d 2d 2d |ilure...|.-------|
|00004190| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000041a0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000041b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000041c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
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|000041e0| 74 75 6d 20 4d 79 6f 63 | 61 72 64 69 74 69 73 20 |tum Myoc|arditis |
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|00004200| 68 79 0d 0a 0d 0a 4d 69 | 64 65 69 20 4d 47 3b 20 |hy....Mi|dei MG; |
|00004210| 44 65 4d 65 6e 74 20 53 | 48 3b 20 46 65 6c 64 6d |DeMent S|H; Feldm|
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|00004230| 47 4d 3b 20 42 61 75 67 | 68 6d 61 6e 20 4b 4c 0d |GM; Baug|hman KL.|
|00004240| 0a 28 4a 6f 68 6e 73 20 | 48 6f 70 6b 69 6e 73 20 |.(Johns |Hopkins |
|00004250| 4d 65 64 20 49 6e 73 74 | 73 29 0d 0a 43 69 72 63 |Med Inst|s)..Circ|
|00004260| 75 6c 61 74 69 6f 6e 20 | 38 31 3a 39 32 32 2d 39 |ulation |81:922-9|
|00004270| 32 38 2c 20 31 39 39 30 | 0d 0a 2d 2d 2d 2d 2d 2d |28, 1990|..------|
|00004280| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004290| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000042a0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000042b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000042c0| 2d 2d 2d 2d 2d 2d 2d 2d | 0d 0a 0d 0a 41 62 73 74 |--------|....Abst|
|000042d0| 72 61 63 74 0d 0a 0d 0a | 20 20 20 20 20 50 65 72 |ract....| Per|
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+--------+-------------------------+-------------------------+--------+--------+
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