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Ann Thorac Surg 1984;37:328-336
© 1984 The Society of Thoracic Surgeons

Articles

Long-Term Results of Cardiac Valve Replacement with the Delrin-Disc Model of the Björk-Shiley Valve Prosthesis

C.G. Montero, M.D.*, J.J. Rufilanchas, M.D., A. Juffe, M.D., R. Burgos, M.D., J. Ugarte, M.D., D. Figuera, M.D.

Servicio de Cirugia Cardiovascular y Torácica, Clínica Puerta de Hierro, Universidad Autónoma de Madrid, Madrid, Spain

Accepted for publication April 14, 1983.

* Address reprint requests to Dr. Montero, Calle Costa Brava 49, Apartamento 1.E, Mirasierra, Madrid 34, Spain

One hundred two Björk-Shiley valve prostheses with the Delrin-disc occluder were implanted in 83 patients between January, 1971, and July, 1972. Fifty-eight were in the mitral position, 42 in the aortic, and 2 in the tricuspid. Complete follow-up until 1981 was obtained in 93% of the patients (mean follow-up, 66.8 months). Hospital mortality was 18% and late mortality, 19%. Survival according to actuarial methods was 84.8% at 5 years and 78.1% at 9 years after operation. Thromboembolism was detected in 8.8% of patients but caused no deaths. The incidence was 1.2% and 1.5% per year in those patients treated with Coumadin and antiplatelet agents, respectively. Reoperation was necessary in 13% of the patients.

Most survivors (72%) are in New York Heart Association Functional Class I, despite a preoperative status of Class III or IV in 57% of the patients. Hospital mortality may be due to poorer understanding of patient management and less refined techniques of myocardial protection. Long-term survival with this prosthesis is similar to that in more recent studies, and rates of thromboembolism and malfunction compare favorably with other prosthetic valves.




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