Results of valve replacement with the Lillehei-Kaster disc prosthesis

Area of Science:

• Cardiovascular Surgery
• Biomaterials Science
• Clinical Medicine

Background:

• The Lillehei-Kaster prosthesis is a mechanical heart valve used for valve replacement surgery.
• Thromboembolism and valve thrombosis are significant complications following prosthetic heart valve implantation.
• Long-term outcomes and complication rates of specific prosthetic valves require continuous evaluation.

Purpose of the Study:

• To review the outcomes of valve replacement using Lillehei-Kaster aortic and mitral prostheses.
• To assess the cumulative thromboembolic-free rate and incidence of valve thrombosis.
• To evaluate the clinical and hemodynamic performance of these prostheses.

Main Methods:

• Retrospective review of 150 patients who underwent valve replacement with Lillehei-Kaster prostheses.
• Actuarial analysis to determine thromboembolic-free rates.
• Clinical assessment of hemodynamic function and monitoring for complications like thrombosis.

Main Results:

• Actuarial analysis revealed a 78% cumulative thromboembolic-free rate at three years post-mitral valve replacement and 89% post-aortic valve replacement.
• Five patients experienced a total of six episodes of mitral valve thrombosis, even with anticoagulant therapy.
• Clinical assessment indicated satisfactory hemodynamic results in patients without thrombosis.

Conclusions:

• Lillehei-Kaster prostheses demonstrate acceptable thromboembolic-free rates for both mitral and aortic valve replacement.
• Mitral valve thrombosis remains a concern, necessitating vigilant monitoring and potentially optimized anticoagulation strategies.
• Clinical evaluation for mitral valve obstruction can be challenging due to subtle auscultatory findings in normally functioning prostheses.