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Ann Thorac Surg 1977;24:131-139
© 1977 The Society of Thoracic Surgeons

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Articles

Late Evaluation of Patients Undergoing Valve Replacement with the Björk-Shiley Prosthesis

Departments of Thoracic and Cardiovascular Surgery and Cardiology, The Medical College of Wisconsin, St Luke's Hospital, Milwaukee County General Hospital, and Wood Veteran's Administration Hospital, Milwaukee, WI

^* Address reprint requests to Dr. Lepley, 9800 W Bluemound Rd, Milwaukee, WI 53226

This study analyzes 484 patients who survived mitral, aortic, or mitral and aortic valve replacement using the Björk-Shiley prosthesis from January, 1970, through December 31, 1974. Long-term follow-up of 1 to 6 years (mean, 3.67 yr) was done on 435 patients (98.2%).

Eighty to 85% of the patients have improved noticeably. Thromboembolic problems occurred in 6.9%, representing 1.5 emboli per 1,000 patient-months. Anticoagulant bleeding problems occurred in 6.4% of the patients; late mortality was 15%.

Actuarial survival curves showed patients at risk to 6 years having a 79% chance of survival. The same analysis according to preoperative New York Heart Association Functional Classification showed a striking reduction in survival in Class IV patients. The Björk-Shiley prosthesis is a good choice for valve replacement today. Earlier diagnosis and treatment are needed to obtain better long-term survival.

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