To assess the long-term results of mitral valve replacement, we reviewed our cases of the 374 patients undergoing mitral valve replacement between March 1982 to February 1992:There were 159 male and 215 female and mean age was 37.8 years.
There were 24 hospital deaths(6.4%);the most commonly from low cardiac output syndrome(12 deaths).We used 314 mechanical valves and 60 tissue valves. Most of all were anticoagulated with coumadin maintaining target level of 1.5~3.0 INR of
prothrombin
time. Follow up was 94% complete(2270 patient-years). There were 12 late deaths: 3 due to hemorrhage, 3 due to cerebral embolism and 6 from various causes.
Overall actuarial survival including hospital mortality, was 82.3% after 10 years of operation.
Linealized rates of late complication events are follows: thromboembolism, 1.3% per patient-year; anticoagulant related hemorrhage, o.5% per patient year.
We analyzed the factors of favorable effect to postoperative course were: preoperative clinical status including NYHA class, first operation, Valve apparatus preservating operation technique, not biggest size of prosthetic valve.
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