A 5-Year- experience of combined aortic and mitral valve replacement(double valve replacement: DVD) was reported. Between Sep. 1986 and Feb. 1992, 25 patients were received such operations. There were 13 males and 12 females ranging in age from
19
to 53
years with the mean age of 38.5±10.0 year.
@ES The results were summarized as follows:
@EN 1. The aortic clamping times(ACT) were ranging from 124 minutes to 221 minutes with the mean ACT time of 174±24.6 minutes. The total bypass times (TBT) were ranging from 147 minutes to 251 minutes with the mean TBT of 200.0±26.1 minutes.
2. Preoperative NYHA functional classes of patients were II (3 cases), III(15 cases), IV(7 cases), and postoperatively 21cases were improved to I(10 cases), II (11 cases).
3. All were rheumatic heart diseases. In mitral sites, stenosis was dominated in 17 cases and regurgitation was dominated in 8 cases. In aortic sites, stenosis was dominated in 15 cases and regurgitation was dominated in 10 cases.
4. Left atrial thrombus was noticed in 3 cases(12.0%) and valve calcification was noticed in 10 cases(40.0%). Combined tricuspid regurgitation was noticed in 7 cases(28.0%), and in which DeVega annuloplasty was applied.
5. St. Jude Medical valves(18 cases) and Carpentier-Edward valves(7 cases) were used. 29mm(9), 31mm(8), 33mm(6), 27mm(2) were used in MVR. 23mm(8), 21mm(8), 19mm(8), 27mm(1) were used in AVP. There were valve combinations such as
M(33mm)-A(23mm),
M(29mm)-A919mm), M(29mm)-A(21mm), M(31Mm)-A(19mm) and others with the case number as 4, 4, 3, 3, and 13 in the order of description.
6. Early postoperative complications were occurred in 10 cases(40.0%) and the early postoperative deaths were occurred in 4 cases(16.0%) with bypass weaning failure (1 case), LOS(1 case), cardiac rupture (1 case), sudden cardiac arrest(1 case).
7. Mean follow-up time of survival 21 cases was 38.3±19.0 months(67 pt.-years). Late postoperative complication was occurred in one case(thromboembolism) and the late postoperative death was also occurred in one case (non cardiac death).
Therefore
complication occurrence rate was 1.4±1.4%/pt-years and 5 year actual survival rate was 83.4±14.2%.
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