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Ann Thorac Surg 1988;46:536-541
© 1988 The Society of Thoracic Surgeons

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Articles

The Ionescu-Shiley Pericardial Valve: Results in 473 Patients

Departments of Cardiovascular Surgery and Biostatistics, University Hospital Gasthuisberg-St. Raphael, Leuven, and the European Association for the Study of Bioprostheses, Brussels, Belgium

Accepted for publication May 26, 1988.

^* Address reprint requests to Dr. Daenen, Department of Cardiovascular Surgery, University Hospital Gasthuisberg, Leuven, Belgium

From January 1, 1980, through December 31, 1985, 473 patients underwent valve replacement with an Ionescu-Shiley valve. Overall hospital mortality was 7.8%. Major associated procedures and preoperative New York Heart Association (NYHA) Classes IV and V influenced hospital mortality significantly. The mean follow-up was 2.6 ± 1.3 years. Late mortality was 5.9%. Overall actuarial survival was 81% at 5 years. A chief cause of reoperation was cusp rupture of a mitral prosthesis in 5 patients (all after aortic and mitral valve replacement). The overall actuarial reoperation-free incidence was 93% at 5 years. Thromboembolic (TB) phenomena occurred at a linear incidence of 1.4 ± 0.3% per patient-year or an actuarial thromboembolism-free incidence of 92% at 5 years. Univariate and multivariate analyses showed that postoperative NYHA Class, rhythm at follow-up, and anticoagulant therapy significantly influenced the incidence of TE phenomena.

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