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Lars I. Thulin
William H. Bain
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Christian L. Olin
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Ann Thorac Surg 1988;45:164-170
© 1988 The Society of Thoracic Surgeons


Articles

Heart Valve Replacement with the Björk-Shiley Monostrut Valve: Early Results of a Multicenter Clinical Investigation

Lars I. Thulin, M.D., William H. Bain, F.R.C.S., Hans H. Huysmans, M.D., Gerrit van Ingen, M.D., Ignatio Prieto, F.R.C.S., Fadi Basile, F.R.C.S., Dan A. Lindblom, M.D., Christian L. Olin, M.D.*

From the Departments of Cardiothoracic Surgery at Lund University Hospital, Lund, Sweden; Western Infirmary, Glasgow, Scotland; Academic Hospital, Leiden, Holland; Hôspital Hotel-Dieu de Montreal, Quebec, Canada; and Karolinska Hospital, Stockholm, Sweden

Accepted for publication August 31, 1987.

* Address reprint requests to Dr. Olin, Department of Thoracic Surgery, Lund University Hospital, S-221 85 Lund, Sweden

To evaluate the clinical performance of the Björk-Shiley Monostrut prosthesis, five centers combined their early experience. Between May, 1982, and June, 1985, 537 prostheses were implanted in 486 patients at these centers: 246 patients had aortic valve replacement (AVR), 163 underwent mitral valve replacement (MVR), and 47 had double-valve replacement (DVR). Thirty patients underwent other, more complex procedures. Concomitant cardiac procedures were performed in altogether 25%. Overall hospital (30 days) mortality was 5.1% (3.6% for AVR, 4.3% for MVR, 8.3% for DVR, and 16.6% for other procedures). The patients were followed up at 6- to 9-month intervals from 6 to 48 months (mean follow-up, 33 months). Follow-up was 99.6% complete. Late mortality was 7.2%. The three-year survival rate was 91.0% for AVR, 92.3% for MVR, and 76.2% for DVR. There was no structural failure of the prosthesis. No instances of valve thrombosis and fatal thromboembolism occurred in anticoagulated patients. The three-year incidence of freedom from thromboembolic events (including TIA) was 89.8% for AVR, 94.9% for MVR, and 90.2% for DVR. Preoperative and postoperative data for the assessment of mechanical hemolysis was available in 60% of the patients. The degree of mechanical hemolysis was low and did not change with time. Although the follow-up is still short, the Björk-Shiley Monostrut prosthesis appears to represent an improvement over previous Björk-Shiley models, particularly with regard to durability.




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