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The Annals of Thoracic Surgery, Vol 30, 439-447, Copyright © 1980 by The Society of Thoracic Surgeons
ML Jacobs, BN Fowler, MP Vezeridis, N Jones and WM Daggett
Experience with aortic valve replacement over a 9-year period is reviewed.
Hospital mortality was 5.0%, with an additional late mortality of 15.0%
during a mean follow-up period of 4.3 years. There was a 7.5% mortality
among the 93 patients who were operated on using direct coronary perfusion.
There were no early deaths among the 48 patients operated on using cold
cardioplegic arrest. Paravalvular leaks developed in 20 patients, and 9 had
reoperation. There were no early deaths following elective reoperations for
prosthetic valve dysfunction, but urgent reoperation was associated with a
40% mortality. Eighty percent of all patients are still alive at a maximum
follow-up of 9 years. Eighty-six percent of the survivors who were in New
York Heart Association Functional Class III or IV before operation are now
in Class I or II. Hypothermic cardioplegic arrest was found to be
preferable to coronary perfusion as a method of myocardial protection
during aortic valve replacement. Patients with paravalvular leaks who have
a history of left ventricular failure prior to aortic valve replacement
should be considered candidates for early elective reoperation, owing to
the significantly greater mortality associated with urgent reoperation.
ARTICLES
Aortic valve replacement: a 9-year experience
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