From Febrary 1984 to July 1992, 138 cases of multiple valve replacements were performed at the department of Thoracic and Cardiovascular Surgery, Dongsan Medical Center, Keimyung University. There were 81 females and 57 males, and their ages
ranged
from
19 to 60 years(mean age, 40.1±10.9 years). Thirteen of these patients had undergone previous cardiovascular procedures, with an average of 76.3 months between procedures(range, 3 to 180 months). Mitral and aortic valve replacement were done in
135
patients, 2 underwent triple valve replacement and 1 underwent mitral and tricuspid valve replacement. Associated procedures were necessary in 20 patients(14.5%). The operative mortality was 5.8% and the most common cause was low cardiac output.
Late
follow-up of 83% has been accomplished in 130 early survivors, with a late mortality f 5.9%. the late mortality was due to valve thrombosis in 2 patients, cerebral infarction in 1, heart failure in 1, arrhythmia in 1, and bleeding in 1. Of those
patients who survived, New Youk Heart Asso0ciation functional class improved significantly(from 70% class III and IV before to 88% class I and II after). Actuarial survival rate including all deaths was 88.8% at 8 years. The follow-up studies
revealed
that thromboembolism, reoperation and bleeding rate were 1.2%/patient-year 0.85%/patient-year and 0.57%/patient-year at 8 years postoperatively. We concluded that valve thrombosis embolism and anticoagulant-related hemorrhage were the main risk
factors
of longterm survival of patients.
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