[Comparative evaluation of Soviet-made mechanical prostheses in the mitral position]

Area of Science:

• Cardiovascular Surgery
• Biomedical Engineering
• Prosthetic Devices

Background:

• Heart valve replacement is a critical surgical procedure.
• Different prosthetic valve designs exist, each with potential advantages and disadvantages.
• Comparative studies are essential to determine optimal prosthetic choices for patient outcomes.

Purpose of the Study:

• To comparatively evaluate the clinical performance of three distinct heart valve prostheses.
• To assess hospital lethality, long-term survival, thromboembolic complications, hemodynamic function, and functional class.
• To identify the most effective prosthesis based on patient outcomes.

Main Methods:

• A comparative appraisal of 25-ball (group 1), rotational-disk (group 2), and other prostheses (group 3).
• Study included 180 patients operated on between 1983 and 1988.
• Postoperative follow-up ranged from 6 months to 5 years, assessing survival, complications, hemodynamic gradients, and functional class.

Main Results:

• Hospital lethality: 7.5% (group 1), 2.7% (group 2), 4.8% (group 3).
• Five-year survival: 76.6% (group 1), 97.3% (group 2), 87.7% (group 3).
• Thromboembolic complications at 5 years: 88.3% (group 1), 97.3% (group 2), 91.5% (group 3). Mean diastolic gradients were lowest in group 2.

Conclusions:

• The rotational-disk prosthesis (group 2) demonstrated significantly better outcomes compared to the 25-ball prosthesis (group 1) and other prostheses (group 3).
• Lower hospital mortality, superior five-year survival rates, and a higher incidence of freedom from thromboembolic complications were observed with the rotational-disk prosthesis.
• Hemodynamic performance and functional class were comparable across groups, but the rotational-disk prosthesis offered the most favorable overall clinical profile.