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Published on: December 11, 2017
The long-term follow up results of Kay-Shiley heart valve prostheses
1Department of Thoracic and Cardiovascular Surgery, Medical Faculty of Hacettepe University, Ankara, Turkey.
Insights
This study evaluated Kay-Shiley disc valve performance in 323 patients, revealing significant early mortality and long-term survival challenges. Thromboembolism and valve failure were key concerns in this early cardiac valve replacement series.
Area of Science:
- Cardiovascular Surgery
- Biomedical Engineering
- Clinical Outcomes Research
Background:
- The Kay-Shiley disc valve was an early prosthetic device used for heart valve replacement.
- Understanding the long-term performance and complications of these early valves is crucial for historical context and future device development.
Purpose of the Study:
- To assess the early and late outcomes of Kay-Shiley disc valve implantation.
- To evaluate survival rates, thromboembolic events, and valve failure in patients undergoing valve replacement.
Main Methods:
- A retrospective analysis of 323 patients who received 336 Kay-Shiley disc valve implants between 1968 and 1975.
- Follow-up ranged from 1 to 16 years, with evaluation of mortality, morbidity, and valve-related complications.
Main Results:
- Early mortality was 16.5% (52 deaths) in the early postoperative period.
- Actuarial survival estimates at 1, 5, and 10 years were 88%, 60.3%, and 36.3%, respectively.
- The incidence of thromboemboli was 4.2% per patient-year, and valve failure due to thrombosis occurred in 3% of cases.
Conclusions:
- The Kay-Shiley disc valve demonstrated significant early mortality and limited long-term survival in this patient cohort.
- Thromboembolic complications and valve thrombosis were notable issues, impacting patient outcomes.
- These findings highlight the challenges associated with early prosthetic valve technology.
Abstract:
Three hundred and thirty six Kay-Shiley disc valves were implanted in 323 cases from 1968 to 1975 at the Hacettepe University Hospital, Ankara. Eight patients died during surgery. Of the 328 valve replacements followed postoperatively, 263 were in the mitral (80.2%), 26 in the aortic (8%) and 39 in the tricuspid position (11.9%). Three hundred and fifteen patients were evaluated in the early and late postoperative periods. In the early period 52 patients died (16.5%). The remaining cases were followed up for 1-16 years (3381 patient-years). Twenty eight patients remain alive at the time of this report (10.6%). The longest survivors are 2 of the mitral valve replacement cases. The actuarial survival estimates were 88 +/- 2.4% at 1 year, 60.3 +/- 3.4% at 5 years, 36.3 +/- 3.9% at 10 years for all cases. The incidence of thromboemboli was 4.2% per patient-year in the late period in both the overall and the isolated MVR groups. Valve failure due to thromboses was detected in 8 patients (3%). Six patients were reoperated on in the late period (2.3%).
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