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Long-term follow-up of patients who underwent single valve replacement with Björk-Shiley prosthesis
Insights
This study evaluated the Björk-Shiley heart valve prosthesis in 118 patients. Surgical improvements reduced hospital mortality, with good long-term functional outcomes for aortic and mitral valve replacement patients.
Area of Science:
- Cardiovascular Surgery
- Biomaterials Science
Background:
- The Björk-Shiley prosthesis is an artificial heart valve used for valve replacement surgery.
- Early outcomes data are crucial for understanding the long-term efficacy and safety of prosthetic heart valves.
Purpose of the Study:
- To assess the clinical outcomes of single heart-valve replacement using the Björk-Shiley prosthesis.
- To evaluate the impact of surgical technique improvements on mortality rates.
- To determine the long-term functional status and complication rates in patients.
Main Methods:
- Retrospective analysis of 118 patients undergoing single heart-valve replacement between 1970 and 1977.
- Comparison of hospital mortality rates between early (1970-1973) and later (1974-1977) periods.
- Assessment of late mortality, functional outcomes (New York Heart Association classes), and complication rates (thromboembolism, anticoagulant-related events).
Main Results:
- Overall hospital mortality was 7% for aortic and 9% for mitral valve replacement.
- Hospital mortality significantly decreased in the later period (5% aortic, 4% mitral) compared to the earlier period (9% aortic, 18% mitral).
- Long-term follow-up showed excellent or improved function in 91% of aortic and 86% of mitral valve recipients; thromboembolism occurred in 8.3% and anticoagulant complications in 13.8%.
Conclusions:
- The Björk-Shiley prosthesis demonstrated acceptable long-term functional results following aortic and mitral valve replacement.
- Improvements in surgical techniques, including myocardial preservation and cardiopulmonary bypass, significantly reduced perioperative mortality.
- While effective, the prosthesis is associated with risks of thromboembolism and anticoagulant-related complications requiring careful management.
Abstract:
Single heart-valve replacement with a Björk-Shiley prosthesis was undertaken in 118 patients between Jan. 3, 1970 and Dec. 31, 1977. The hospital mortality was 7% for patients who had aortic valve replacement and 9% for those who had mitral valve replacement. Recent improvements in techniques for myocardial preservation and cardiopulmonary bypass resulted in a notable reduction in hospital mortality during the period 1974 to 1977 compared with that in the period 1970 to 1973; the rate was 5% for aortic valve replacement and 4% for mitral valve replacement between 1974 and 1977 compared with 9% and 18%, respectively, during the period 1970 to 1973. There was an additional late mortality of 8% in patients who had an aortic valve replaced and 11% in those who had a mitral valve replaced; the mean follow-up was 2.3 years (range 6 months to 7.5 years). Seventy-one patients with an aortic valve prosthesis and 38 patients with a mitral valve prosthesis were alive at the time of late follow-up. In patients who received an aortic valve prosthesis, 73% had an excellent result after operation (New York Heart Association classes I or II) and 18% had some functional improvement. In patients who received a mitral valve prosthesis, 68% had an excellent result and 18% were functionally improved after operation. The incidence of thromboembolism was 8.3% and of anticoagulant-related complications, 13.8%.