[Long-term results (6 to 17 years) of 372 mitral valve replacements using the Björk-Shiley prosthesis]

From November 1970 to December 1981, an isolated mitral valve replacement was performed in 372 patients (166 males - 206 females), ranging in age from 2 months to 76 years (mean age 49 years). Eighty-nine patients (24%) had previously undergone one or two cardiac operations. Only one of the 24 hospital deaths (6.4%) was related to the prosthesis (early thrombosis). Three hundred and fourty-eight patients were discharged from the hospital, 35 were lost to follow-up, and 313 were observed with a mean follow-up of 8 years 8 months (ranging from 5 years 2 months to 16 years 3 months). Ninety-two patients (29.4%) died from 2 months to 16 years post-operatively. Thirteen late deaths were from extra cardiac causes. Cardiac failure and thromboembolic or haemorrhagic complications represent the main causes of late mortality, respectively 10 and 6.7%. Twenty-one deaths were related to the prosthesis (10 thrombo-embolic accidents, 7 haemorrhagic complications and prosthesis could be discussed in 11 cases of sudden deaths and in 12 cases of death of undetermined causes. Among the 34 thrombo-embolic complications and the 13 perivalvular leakages (6 of them related to infection), 23 patients required reoperation, for valve thrombosis (14 cases with 2 deaths) or perivalvular leakage (9 cases with 2 deaths). Four other cases of valve thrombosis were treated with fibrinolytic agents with 1 death. The actuarial survival rate, hospital mortality excluded, is 69% at 10 years and 55% at 15 years.(ABSTRACT TRUNCATED AT 250 WORDS)