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Mitral valve replacement: a comparison of two prostheses

J R Rees, G R Holswade, R G Carlson

    Chest
    |February 1, 1977
    PubMed
    Summary

    The Smeloff-Cutter mitral prosthesis showed better outcomes than the toroidal valve in patients undergoing mitral valve replacement. It resulted in lower mortality and fewer thromboembolic complications.

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    Area of Science:

    • Cardiovascular Surgery
    • Biomedical Engineering
    • Clinical Trials

    Background:

    • Mitral valve replacement is a critical procedure for managing severe mitral valve disease.
    • Comparing prosthetic valve performance is essential for optimizing patient outcomes.
    • Early prosthetic designs presented distinct risks and benefits.

    Purpose of the Study:

    • To compare the long-term efficacy and safety of the Smeloff-Cutter prosthesis versus the toroidal valve for mitral valve replacement.
    • To evaluate differences in mortality, thromboembolic events, and reoperation rates between the two prosthetic valves.

    Main Methods:

    • A retrospective study involving 175 patients who underwent mitral valve replacement between November 1965 and June 1970.
    • Patients received either the Smeloff-Cutter prosthesis (109 patients) or the toroidal valve (66 patients).

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  • Follow-up extended for at least five years, assessing mortality, thromboembolism, and reoperation due to thrombosis.

    • Main Results:

    • The Smeloff-Cutter group had lower early (15.6%) and late (23.9%) mortality compared to the toroidal group (18.2% early, 34.8% late).
    • Thromboembolic complications were significantly lower in the Smeloff-Cutter group (7.6%) versus the toroidal group (25.9%).
    • Fewer reoperations for prosthesis thrombosis occurred in the Smeloff-Cutter group (2) compared to the toroidal group (7).

    Conclusions:

    • The Smeloff-Cutter mitral prosthesis demonstrated superior performance compared to the toroidal valve.
    • A lower incidence of thromboembolism is a key advantage of the Smeloff-Cutter prosthesis.
    • These findings support the selection of the Smeloff-Cutter prosthesis for improved patient survival and reduced complications.