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The Annals of Thoracic Surgery, Vol 30, 247-258, Copyright © 1980 by The Society of Thoracic Surgeons
JB Williams, RB Karp, JW Kirklin, NT Kouchoukos, AD Pacifico, GL Zorn Jr, EH Blackstone, RN Brown, S Piantadosi and EL Bradley
From November, 1973, through June, 1978, 428 operations in 425 patients
were performed for replacement of aortic, mitral, or aortic plus mitral
valves, utilizing 277 Hancock and 180 Carpentier-Edwards bioprostheses.
Actuarially determined survival at 36 months was similar for all three
groups and compared favorably with our experience with the Bjork-Shiley
prosthesis. Certain patient-related variables influencing late survival
were identified by multivariate analysis and included previous operation
for congenital heart disease, coronary artery bypass grafting in nonaortic
valve replacement, race (black), age at operation, and New York Heart
Association Functional Class. A small but definite incidence of
thromboembolism occurred in all three groups, again similar to our
experience with the Bjork-Shiley prosthesis. Multivariate analysis
identified four factors influencing risk of thromboembolism: previous
cardiac operation, age, double-valve replacement, and rhythm at discharge.
Valve degeneraation occurred, primarily in children and young adults. Over
the medium term, the porcine bioprosthesis compared favorably with
mechanical prostheses in terms of survival, function, and thromboembolism.
Certain patient-related variables affecting survival may be modified by
earlier surgical intervention.
ARTICLES
Considerations in selection and management of patients undergoing valve replacement with glutaraldehyde-fixed porcine bioprotheses
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