The Annals of Thoracic Surgery, Vol 35, 651-663, Copyright © 1983 by The Society of Thoracic Surgeons
Nine years' experience with the Bjork-Shiley prosthetic valve: early and late results of 932 valve replacements
W Daenen, A Nevelsteen, P van Cauwelaert, E de Maesschalk, J Willems and G Stalpaert
Between November, 1970, and December, 1977, 932 consecutive patients
received the standard Bjork-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
greater than 0.2) or aortic insufficiency alone (p greater than 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.
