Between Oct. 1985 and July 1995, 230 patients underwent mitral valve replacement. There were 77 men and 153 women whose mean age was 35.7 years, range 9 to 62. The concomitant operations were 40 aortic valve replacements(17.4%), 25 tricuspid
annuloplasties(10.4%), 8 aortic valve replacements & tricuspid annuloplasties(3.5%), 2 tricuspid valve replacements(0.9%) and others. We used 139 mechanical (76 St. Jude medical, 33 CarboMedics, 30 Sorin) and 91 tissue (86 Carpentier-Edwards, 5
Ionescu-Shiley)valves.
The early postoperative complications occurred in 28 cases. There were 8 low cardiac output syndrome, 5 pleural effusion, 3 significant arrhythmia, 2 cardiac rupture and others. There were 6 early hospital deaths (2.6%) due to low cardiac output
syndrome(2), arrhythmia(2) and ventricular rupture(2). The cummulative total follow-up period was 764.4 patient-years with a mean of 43.9 months. The long term follow-up information was available for 212 patients(94.6%). There were 21 cases of
valve-related complications. Prosthetic valve failure(10), anti-coagulation related bleeding(5), prosthetic valve endocarditis(4), and thromboembolism(2) occurred at rates of 1.3, 0.7, 0.5, and 0.3%/pt-yr respectively. Late death occurred in 5
cases(0.7%/pt-yr) associated with prosthetic valve endocarditis(2), heart failure(2) and anti-coagulation related bleeding(1). There was no difference in the rate of freedom from prosthetic valve failure between the mechanical and tissue valve
group at
6 years(100%), but there was significant difference at 9 years between the tissue(34.4%) and mechanical valve(100%) group(p=0.032). Actuarial survival rates were 98.8% in tissue valve, 93.7% in mechanical valve group and 96.6% in total patients
at
9
years.
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