216:
similar pericardial valves. None of these showed a better performance than the original
Ionescu valve with the exception of a pericardial valve modified and built by Edwards Laboratories and commercialised under the name of 'Carpentier-Edwards Pericardial Bioprosthesis.' This valve is reported to perform better than its predecessor, the original Ionescu–Shiley valve. However, a correct comparison between these two valves cannot be made because the Ionescu valve had been used by most surgeons in patients of all age groups and mostly younger than 65 years, as was the custom in the Seventies and Eighties. The Edwards valve, on the other hand, is being used since the mid-eighties almost exclusively in patients above the age of 65–70 years in whom the risk of primary valve failure is now known to be significantly lower.
201:
Xenograft'. Its use by
Ionescu and many other surgeons demonstrated very good performance in all aspects until 6 to 10 years post-operatively when signs of malfunction appeared progressively in younger patients and some of the valves had to be removed and replaced. Although a small percentage of the pericardial valves continued to function normally for up to 26 years post-implantation, the majority of them had to be replaced between 6 and 14 years, and a few some time later.
173:
these valves in April 1969. This procedure of valve construction and implantation had been used in many centres in the world for about three years until it was realised that fascia lata did not perform well over longer periods of time in the high pressure environment of the left heart. These valves became incompetent after various durations after implantation – from 3 to 12 years. However, two important facts were established by the use of such valves. The
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98:(21 August 1929 – 12 October 2023) was a Romanian-born British cardiac surgeon. His interest in heart surgery covered several aspects of this specialty. He was an inventor of surgical devices, mostly artificial heart valves, a scientist in the broad term and a medical educator. Ionescu died on 12 October 2023, at the age of 94.
200:
fatigue testing. In March 1971 Ionescu began the clinical implantation, for the first time, of this original device. The results were very encouraging. In 1976 Shiley
Laboratory in California began to manufacture and to distribute worldwide this valve under the name of 'Ionescu–Shiley Pericardial
172:
tissue (the fibrous membrane which covers the outside aspect of the thigh muscles) taken from the patient and used to construct the valve during the operation by mounting the living fascia on a Dacron-covered titanium frame in the shape of a three cusp valve. He began the clinical implantation of
245:
cardiac diseases he created and built, initially in his hospital laboratory, two original devices: the 'mono-cusp patch' for the correct enlargement of the narrowed pulmonary artery and annulus and a valved conduit (a tube containing a three-cusped valve) for cases with discontinuity between the
215:
Some 10 years after the creation of the pericardial valve by
Ionescu, and its use by numerous surgeons and after having demonstrated its excellent haemodynamic performance and the reduced propensity for thrombo-embolism, other companies began manufacturing and distributing a plethora of rather
106:
Marian
Ionescu's entire medical career was dominated by scientific curiosity and a persistent desire and ability to make progress by creating change, by discovering the unknown, by improving the known and by inventing what he thought would be useful.
279:"The creation of the stented pericardial valve opened a door towards further potential improvements, as this valve, being entirely man-made, lends itself to a multitude of permutations of shape in order to further improve its long term performance."
130:, with the aid of extracorporeal circulation, in animals and in man. The body temperature was lowered to between 6 and 15 °C and complete circulatory arrest of up to 56 minutes was maintained without significant negative effects.
219:
Ionescu also created the concept of performing multiple sequential haemodynamic investigations of patients following heart valve surgery, to evaluate, in time, the patient's condition.
412:
Obtained 12 Awards and
Honorary titles, the latest being the Society of Cardiothoracic Surgery in Great Britain and Ireland Lifetime Achievement Award for Cardiac Surgery (March 2015)
157:). With various modifications and improvements, these stent mounted valves had been implanted in 87 patients between February 1967 and March 1969. All these valves were treated with
617:
Ionescu M I, Holden M D, Petrila P A "Fascia Lata Heart Valves; with section on Free Fascia Lata Grafts for Aortic Valve
Replacement" In: Ionescu M I, Ross D N, Wooler G H, Eds.
268:
Ionescu practised high altitude climbing in the
Northern Alps and the Himalayas where, during three expeditions, he stood on the top of five peaks around 7000 meters high.
185:
was minimal when compared with mechanical valves. Freehand insertion of stentless fascia lata aortic valves was also used in a small number of cases with similar results.
188:
In his continuous search for the 'Holy Grail', Ionescu experimented with valves made from bovine pericardium (the membrane which surrounds the heart) treated with
917:
578:
Ionescu M I, Smith D R, Petrila P A, Wooler G H, "Heart Valve
Replacement with Supported Aortic Heterografts". In: Ionescu M I, Ross D N, Wooler G H, Eds.
847:
713:
Cosgrove A M, Lytle B W, Taylor P C, Camacho M T, Stewart R W, et al (1995) "The
Carpentier–Edwards pericardial aortic valve; ten-year results",
161:
and this was the main reason for their limited durability. In a continuous search to create a tissue heart valve which could be used without
922:
291:
Original scientific articles on various aspects of cardiovascular and thoracic surgery have been published in several medical journals.
907:
821:
458:
438:
787:
Ionescu M I, Deac R C,(1970),"Fascia Lata Composite Graft for Right Ventricular Outflow Tract and Pulmonary Artery Reconstruction",
635:
630:
Ionescu M I, Tandon A P, Mary D A S, Abid A, (1977), "Heart Valve Replacement with the Ionescu–Shiley Pericardial Xenograft",
192:
and mounted on a Dacron covered titanium frame. This original valve, designed and created by Ionescu, demonstrated excellent
757:"Sequential Hemodynamic Studies in Patients having Aortic Valve Replacement with the Ionescu–Shiley Pericardial Xenograft"
122:
formation. During 1961 and 1962 in Romania, he conducted, with his team, extensive experimental and clinical work on the
471:
125th Anniversary Exhibition at The General Infirmary at Leeds since the opening of the Gilbert Scott Building 1868–1993
153:
frame for mounting the porcine aortic valves to be able to implant them in all three cardiac locations (mitral, aortic,
549:
Ionescu M I, Wooler G H, Smith D R, Grimshaw V A (1967), "Mitral Valve Replacement with Aortic Heterografts in Humans"
177:
performance in both mitral and aortic positions was superior to all known artificial heart valves and that the risk of
604:
Ionescu M I, Deac R C,Whitaker W, Wooler G H, "Fascia Lata Heart Valves", In: Ionescu M I,Ross D N, Wooler G H, Eds.
912:
902:
276:"Progress is a continually ascending spiral, a stepwise extension of the horizon and of the quality of knowledge."
646:
Ionescu M I, Tandon A P, Silverton N P, Chidambaram M, Smith D R,"Long term Durability of the Pericardial Valve",
802:
Ionescu M I,Macartney F J, Wooler G H, (1973),"Intracardiac Repair of Single Ventricle with Pulmonary Stenosis",
815:
Gonzalez-Lavin L. (1988) "Letter to the editor, on the retirement of Marian I. Ionescu from clinical practice."
517:
Robicsek F "The Application of Biological Tissue in Cardiac Valve Surgery. The History of the First Two Decades
223:
860:
Gonzalez-Lavin L, (1988), "Letter to the Editor, on the retirement of Marian Ionescu from clinical practice",
476:
897:
892:
254:. These devices were made of fascia lata and later, using glutaraldehyde treated bovine pericardium.
742:
Ionescu M I, Tandon A P,"The Ionescu–Shiley Pericardial Xenograft Heart Valve", In: Ionescu M I Ed.
726:
Thamilarasan N, Griffin B, (2002), "Choosing The Most Appropriate Heart Operation and Prosthesis",
672:
Blackstone E H (2005) "Could it Happen Again? The Bjork–Shiley Convexo-Concave Heart Valve Story",
872:
Ionescu M I, Tandon A P, Silverton N P, et al,"Long Term Durability of the Pericardial Valve",
841:
454:
434:
227:
209:
251:
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53:
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208:. At around that time a series of severe problems were encountered with the mechanical
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Indiana University Press (1992), Bloomington, Indianapolis. pages 199,269,310,313–315
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and continued to use various techniques for the repair of such a complex abnormality.
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162:
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226:, Ionescu was the first surgeon to successfully reconstruct a heart with a single
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cloth collar, starting in February 1967. This was followed by the creation of the
110:
In 1959 in Cleveland, at Dr Kolff's impulse, he created the first 'single leaflet
874:
Proceedings of the Cardiac Prosthesis Symposium III, Montreux, Switzerland, 1985,
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127:
648:
Proceedings of the Cardiac Prosthesis Symposium III, Montreux,Switzerland, 1985
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591:
Ionescu M I, Ross D N, "Heart Valve Replacement with Autologous Fascia Lata",
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Perspectives in Cardiothoracic Surgery - The SCTS Ionescu University, Volume I
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166:
123:
364:
The Pericardial Heart Valve - The Odyssey of a Continuously Evolving Concept
233:
154:
32:
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Pericardial valved conduit from the right ventricle to the pulmonary artery
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526:
242:
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Lectures given by invitation at various universities and medical centres
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204:
In the mid-eighties Shiley Company was acquired by the drug laboratory
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142:
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111:
259:
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773:"Intracardiac Repair of Single Ventricle With Pulmonary Stenosis"
650:, Shiley Incorporated, (1987), Irvine, California, pages 111–119
119:
118:. This device never went beyond the experimental stage due to
687:
Bodnar E, Yacoub M, Eds. "Biologic and Bioprosthetic Valves"
396:
Visits for 'round table' or surgical operative demonstrations
700:
Bodnar E, Yacoub M, eds. "Biologic and Bioprosthetic Valves"
659:
Bodnar E, Yacoub M,Eds,"Biologic and Bioprosthetic Valves,"
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treatment, Ionescu created a novel artificial valve. Using
474:
133:
At Leeds Ionescu designed, created and implanted in the
755:
Tandon A P, Smith D R, Mary D A S, Ionescu M I,(1977),
704:, Yorke Medical Books, (1986), New York, pages 643–759.
691:, Yorke Medical Books, (1986), New York,pages 163–225,
569:
ISIS Medical Media, (1997), Oxford, pages 157–159,168
453:
ISIS Medical Media, (1997) Oxford,pages 157–159,168,
330:
I Trapianti Valvorali Cardiaci con Tessuti Biologici.
264:
Ionescu on the Peutrey Ridge to the Mont Blanc summit
663:
Yorke Medical Books, (1986), New York, pages 163–225
257:
In 1987, Ionescu retired from active surgical work.
804:
The Journal of Thoracic and Cardiovascular Surgery,
776:
The Journal of Thoracic and Cardiovascular Surgery,
632:
The Journal of Thoracic and Cardiovascular Surgery,
85:
77:
61:
39:
23:
309:Circulatia Extracorporeala si Hipotermia Profunda.
661:Proceedings of the Third International Symposium,
538:Circulatia Extracorporeala si Hipotermia Profunda
384:Papers presented at different scientific meetings
337:Current Techniques in Extracorporeal Circulation.
702:Proceedings of the Third International Symposium
689:Proceedings of the Third International Symposium
876:Shiley Incorporated, (1987), Irvine, California
715:Journal of Thoracic and Cardiovascular Surgery,
771:Ionescu M I, Macartney F J, Wooler G H (1973)
621:, Butterworths, (1972), London, pages 673–685.
582:, Butterworths, (1972), London, pages 467–513.
358:Mitral Valve Disease, Diagnosis and Treatment.
318:Ed Academia R.P.R, (1965) Bucharest, Romania.
297:Chapters were published in books and treatises
746:, Butterworths, (1979), London, pages 201–252
323:Biological Tissue in Heart Valve Replacement.
137:position in humans, for the first time ever,
8:
606:Biological Tissue in Heart Valve Replacement
580:Biological Tissue in Heart Valve Replacement
608:Butterworths,(1972), London, pages 617–865.
483:Woodgate Graphic Design Consultants, Leeds.
619:Biological Tissue in Heart Valve Replacent
31:
20:
351:Techniques in Extracorporeal Circulation.
862:Journal of Cardiac Surgery, 31, 1, 85–86
761:Annals of Thoracic Surgery, 24, 149–155.
314:Marinescu V., Pausescu E., Ionescu M.I.
196:performance with good durability during
422:
311:Ed Academia R.P.R, Bucharest, Romania.
846:: CS1 maint: archived copy as title (
839:
316:Catecolaminele, Biologie si Patologue.
332:. Edizioni E.M.S.A., (1972), Napoli.
328:Ionescu M.I., Ross D.N., Wooler G.H.
321:Ionescu M.I., Ross D.N., Wooler G.H.
7:
728:Cleveland Clinic Journal of Medicine
540:Editura Academiei, (1962), Bucharest
16:British cardiac surgeon (1929–2023)
918:British people of Romanian descent
14:
431:The Evolution of Cardiac Surgery.
406:Member of 23 Scientific Societies
303:Books written/edited as follows:
521:Journal of Heart Valve Disease
360:Butterworths, (1985), London.
339:Butterworths, (!976), London.
1:
567:Landmarks in Cardiac Surgery,
494:"A Tribute to Marian Ionescu"
451:Landmarks in Cardiac Surgery.
353:Butterworths,(1981), London.
346:Butterworths,(1979), London.
325:Butterworths, (1972) London.
241:For the repair of congenital
141:aortic valves attached to a
817:Journal of Cardiac Surgery,
939:
335:Ionescu M.I., Wooler G.H.
30:
908:British cardiac surgeons
595:294, 7616, pages 335–338
356:Ionescu M.I., Cohn L.H.
224:congenital heart disease
126:of organisms under deep
409:Holder of 6 Fellowships
307:Collective Work (1962)
923:People from Târgoviște
265:
238:
372:SCTS, (2016), London
263:
236:
565:Westaby S, Bosher C,
479:22 July 2011 at the
449:Westaby S, Bosher C,
366:SCTS, (2015) London
344:Tissue Heart Valves.
744:Tissue Heart Valves
676:, 111, 2717–2719 |
429:Shumacker H B Jr.
376:Oral presentations
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96:Marian Ion Ionescu
913:British inventors
903:Romanian surgeons
536:Collective Work,
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81:Romanian, British
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222:In the field of
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828:on 3 March 2016
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69:(aged 94)
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210:Bjork–Shiley
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194:hydrodynamic
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183:embolisation
175:haemodynamic
159:formaldehyde
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116:polyurethane
109:
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67:(2023-10-12)
18:
898:2023 deaths
893:1929 births
819:3,1,85–86 |
778:65, 602–607
674:Circulation
593:The Lancet,
170:fascia lata
128:hypothermia
78:Nationality
887:Categories
832:4 November
806:65,602–607
417:References
179:thrombosis
167:autologous
124:physiology
86:Occupation
54:Târgoviște
46:1929-08-21
503:5 January
228:ventricle
155:tricuspid
56:, Romania
842:cite web
477:Archived
250:and the
243:cyanotic
198:in-vitro
151:titanium
149:covered
102:Medicine
789:Thorax,
551:Thorax,
212:valve.
139:porcine
457:
437:
401:Awards
272:Quotes
206:Pfizer
147:Dacron
143:Teflon
135:mitral
112:aortic
72:Monaco
848:link
834:2009
505:2024
498:SCTS
455:ISBN
435:ISBN
181:and
120:clot
62:Died
40:Born
388:122
382:186
289:242
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