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The Annals of Thoracic Surgery, Vol 24, 131-139, Copyright © 1977 by The Society of Thoracic Surgeons

ARTICLES

Late evaluation of patients undergoing valve replacement with the Bjork- Shiley prosthesis

D Lepley Jr, RJ Flemma, DC Mullen, H Singh and S Chakravarty

This study analyzes 484 patients who survived mitral, aortic, or mitral and aortic valve replacement using the Bjork-Shiley prosthesis from January, 1970, through December 31, 1974. Long-term follow-up of 1 1/2 to 6 1/2 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 Bjork-Shiley prosthesis is a good choice for valve replacement today. Earlier diagnosis and treatment are needed to obtain better long-term survival.