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Ann Thorac Surg 1993;56:131-136
© 1993 The Society of Thoracic Surgeons
Department of Surgical Research, URA CNRS 1431, and Department of Thoracic and Cardiovascular Surgery, CHU, Hôpital Henri Mondor, Faculté Médecine, Créteil, France
Accepted for publication November 19, 1992.
* Address reprint requests to Dr Loisance, Faculté de Médecine, Centre de Recherches Chirurgicales, 8, rue du Général Sarrail, 94000 Créteil, France.
Isolated aortic (n = 107), mitral (n = 63), and tricuspid (n = 1) valve replacement and 28 double-valve replacements were performed with a second generation of pericardial valves, the Mitroflow valve, in 199 patients from March 1983 to December 1986. Follow-up (total, 1,058 patient-years) was extended to 106 months and 91.5% complete. Mean age was 58 ± 13 years. The operative mortality included 22 deaths, non-cardiac-related in 7. The actuarial probability of survival for all patients was 66% ± 4% at 8.5 years. There were no significant differences between patients with aortic valve replacement, mitral valve replacement, or double-valve replacement. The rate of thromboembolic events, antithromboembolic therapy-related hemorrhage, periprosthetic leak, and endocarditis is extremely minimal. Structural valve dysfunction occurred at a rate of 3.2% ± 0.5%/patient-year. Actuarial freedom from the event was 94.6% ± 1.7% at 5 years and 63.7% ± 6.5% at 8.5 years for all valves. There were no difference in structural valve dysfunction rate between patients having aortic, mitral, or double-valve replacement. Thirty-five patients were reoperated on (3.4 ± 0.6%/patient-year for all). The rate of all valve-related morbidity and mortality was 5.6% ± 0.7%/ patient-year for all patients, actuarial freedom from the event being 44% ± 7% at 8.5 years. These data suggest that the excellent hemodynamic characteristics of the valve are balanced by a risk of valve failure that is slightly increased when compared with porcine valves.
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