Aortic and mitral valve replacement with cloth-covered Braunwald-Cutter prosthesis. A three-year follow-up

From February, 1971, through February, 1974, heart valves of 510 patients were replaced with cloth-covered Braunwald-Cutter prostheses. The data indicate that cloth encapsulation of the prosthetic cage is associated with a reduction in thromboembolic complications, particularly for mitral valves. Cloth wear on the distal strut, however, is not prevented by use of a Silastic poppet and appears to be a typical finding in aortic valves recovered or inspected after 3 months. Excessive poppet wear has also been noted in the aortic position; poppet embolization has occurred on 2 occasions, and a third patient was found, at the time of reoperation for periprosthetic leak, to have opppet wear sufficient to permit embolization. Although there have been no reports of clinical malfunction of the mitral prosthesis at the time of this writing, further long-term observation of these patients appears warranted.