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Ann Thorac Surg 1980;29:415-422
© 1980 The Society of Thoracic Surgeons

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Articles

Emergency Heart Valve Replacement: An Analysis of 170 Patients

Division of Cardio-Thoracic Surgery, University of the Witwatersrand, and the Johannesburg Group of Teaching Hospitals, Johannesburg, South Africa

Accepted for publication July 11, 1979.

^* Address reprint requests to Professor Kinsley, Division of Cardio-Thoracic Surgery, University of the Witwatersrand, Medical School, Johannesburg 2001, South Africa

The results of 170 emergency heart valve procedures performed during a 4 1/2-year period were analyzed. Five pathological groups of patients were recognized: those with infective endocarditis (Group 1, 28 patients); acute rheumatic carditis (Group 2, 43 patients); previous valve operation (Group 3, 29 patients); acute-on-chronic cardiac disease (Group 4, 67 patients); and miscellaneous conditions (Group 5, 3 patients). Mitral, aortic, and multiple valve procedures were performed on 58, 65, and 44 patients, respectively. The most common functional lesion was regurgitation. Hospital mortality was highest in Groups 3 (34%) and 4 (31%). By contrast, among the hospital survivors, the highest rate of attrition was in Group 2. Myocardial failure was the predominant cause of death. In view of the hopeless prognosis without operation, the 52% overall 3-year actuarial survival is a gratifying salvage. Unnecessary procrastination can only jeopardize the prospects for surgical cure.

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