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European Journal of Cardio-Thoracic Surgery, Vol 3, 312-319, Copyright © 1989 by European Association for Cardio-thoracic Surgery
A Milano, U Bortolotti, A Mazzucco, F Guerra, A Magni, G Stellin and V Gallucci
The performance of the standard Hancock porcine bioprosthesis (HPB), the
Bjork-Shiley spherical disc prosthesis (BSP) and the Lillehei- Kaster
tilting disc prosthesis (LKP) was compared over a 15-year follow- up in
patients who underwent isolated mitral valve replacement (502 HPB, 183 LKP
and 119 BSP). The cumulative duration of follow-up is 3,488 patient-years
(mean, 8.0 +/- 3.7 years) for patients with a HPB, 1,302 patient-years
(mean, 8.4 +/- 4.9 years) for patients with a LKP and 718 patient-years
(mean, 7.1 +/- 5.6 years) for those with a BSP. At 15 years a significant
difference was found among the 3 groups in freedom from (1)
anticoagulant-related haemorrhages, between HPB (83% +/- 7%) and BSP (65%
+/- 8%) recipients (P less than 0.05); (2) prosthetic dysfunction, BSP (96%
+/- 3%) and LKP (83% +/- 6%) versus HPB (42% +/- 5%) recipients (P less
than 0.001); (3) overall reoperations, BSP (94% +/- 3%) and LKP (89% +/-
3%) versus HPB (40% +/- 5%) recipients (P less than 0.001) and (4)
prosthetic failure, BSP (88% +/- 4%) and LKP (71% +/- 6%) versus HPB (38%
+/- 5%) recipients (P less than 0.001). No difference was found in
actuarial survival, freedom from thromboembolic episodes, treatment failure
and overall prosthesis- related complications. Our results confirm that the
long-term performance of the HPB in the mitral position is adversely
affected by the high incidence of tissue degeneration while haemorrhagic
complications may limit the advantage of the longer durability of
mechanical prostheses.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Mitral valve replacement with the Hancock, Bjork-Shiley and Lillehei- Kaster prostheses. A comparison based on a 15-year follow-up
Department of Cardiovascular Surgery, University of Padova Medical School, Italy.
This article has been cited by other articles:
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A. Mazzucco, P. Morea, A. Milano, and U. Bortolotti Concentric wear of the Delrin disc of a Bjork-Shiley prosthesis: An uncommon cause of prosthetic incompetence J. Thorac. Cardiovasc. Surg., January 1, 1994; 107(1): 318 - 319. [Full Text] |
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