ABSTRACT
One hundred and twenty-one patients who received 145 Cross-Jones prostheses between 1967 and 1973 were followed for over 20 years. Thirty-six patients had undergone single aortic valve replacement, receiving an uncovered prosthesis (Group A), while 83 of the 85 patients in Group B undergoing isolated mitral or combined mitral and aortic and/or tricuspid replacements received a cloth-covered prosthesis in the mitral and/or tricuspid position. There were no mechanical failures in Group A, and three patients are alive 24 years after their operations. The seat was smooth in all prostheses inspected at autopsy and the disc was not worn even 15-18 years after surgery. The overall incidence of thromboembolism in this group was 3.56%/pty, of which 2.13%/pty were fatal. All operative offvivors with cloth-covered valves developed mechanical dysfunction leading to death or requiring reoperation within ten years. The cloth cover was invariably disrupted and the disc hitting this rough surface had become worn, with significant diminution in their diameters in all valves recovered during reoperation or at autopsy. In seven patients, the disc escaped from a mitral prosthesis causing immediate death, while one patient survived a tricuspid disc escape for over one month and was then successfully reoperated. The overall incidence of thromboembolism in Group B was 23.4%/pty, of which 11.7%/pty were fatal.
Subject(s)
Heart Valve Prosthesis/statistics & numerical data , Actuarial Analysis , Adult , Aortic Valve/surgery , Endocarditis/epidemiology , Endocarditis/mortality , Female , Follow-Up Studies , Heart Valve Prosthesis/mortality , Hospital Mortality , Humans , Incidence , Male , Middle Aged , Mitral Valve/surgery , Prospective Studies , Prosthesis Design , Prosthesis Failure , Reoperation/statistics & numerical data , Surface Properties , Survival Rate , Thromboembolism/epidemiology , Thromboembolism/mortality , Tricuspid Valve/surgeryABSTRACT
Computer aided data processing of the results of surgery in 504 patients with mitral (and mitral + aortic + tricuspid) valvular disease, operated on by the Szeged cardiosurgery group between 1966-1983 are discussed. Late results after valve surgery are investigated from the point of view of survival time, functional state and social rehabilitation. Statistical evaluation of postoperative complications and the functional life-time of the Cross-Jones prosthesis are reported. The functional rehabilitation following the operation is mathematically assessed.
