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Ann Thorac Surg 1983;35:651-663
© 1983 The Society of Thoracic Surgeons

Articles

Nine Years' Experience with the Björk-Shiley Prosthetic Valve: Early and Late Results of 932 Valve Replacements

W. Daenen, M.D.*, A. Nevelsteen, M.D., P. van Cauwelaert, M.D., E. de Maesschalk, Ph.D., J. Willems, M.D., G. Stalpaert, M.D.

From the Departments of Cardiovascular Surgery and Biostatistics, University Hospital St. Raphaël, Leuven, Belgium

Accepted for publication April 20, 1982.

* Address reprint requests to Dr. Daenen, Department of Cardiovascular Surgery, University Hospital St. Raphael, B-3000 Leuven, Belgium

Between November, 1970, and December, 1977, 932 consecutive patients received the standard Björk-Shiley prosthesis. Operative mortality was 4.6% for aortic valve replacement (AVR; N = 364), 5.1% for mitral valve replacement (MVR; N = 313); 11.3% for multiple valve replacement (N = 194), and 13.7% for valve replacement combined with coronary artery bypass grafting (CABG; N = 51). Factors influencing hospital mortality included type of valve replacement, age at operation, whether the valve replacement was done as an emergency, and year of implantation.

Complete follow-up (mean, 3.7 years) was achieved in 95% of the survivors. Actuarial survival was 82% for AVR patients at 8 years, 83% for MVR patients at 7 years, 72% for multiple valve replacement patients at 7 years, and 76% for those who had valve replacement with CABG at 3 years. No significant difference in late survival was found between patients with mitral insufficiency alone (p > 0.2) or aortic insufficiency alone (p > 0.9) and those with stenotic lesions only.

Thromboembolic complications occurred at an incidence of 1.17% per patient-year, and Dicumarol-induced hemorrhages occurred at an incidence of 2.11% per patient-year. Twelve out of 13 patients survived operation for prosthetic valve thrombosis, indicating that this complication is not as catastrophic as many believe. The incidence of reoperation in anticoagulated patients was 0.63% per patient-year. All of these results are compared with data from the recent literature.




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