[Comparative evaluation of various methods of treatment of mitral valve diseases. Apropos of 4 series of 100 patients operated on using the Starr prosthesis, Bjork prosthesis, bioprosthesis and valve reconstruction]. / Evaluation comparative de différentes méthodes de traitement des valvulopathies mitrales. A propos de quatre séries de 100 malades opérés par prothèse de Starr, prothèse de Björk, bioprothèse et reconstruction valvulaire.

The results of 4 groups of 100 patients undergoing mitral valvuloplasty (group I), isolated mitral valve replacement by a bioprosthesis (group II), a Starr-Edwards prosthesis (group III) and a Björk prosthesis (group IV) between 1974 and 1977 were compared. The selection of patients for each group was identical and made according to strict criteria. The average age was between 47.1 +/- 12.5 years and 51.8 +/- 10.5 years according to the particular group; the average functional classification was 2.4 +/- 0.4 to 2.5 +/- 0.6; the average cardiothoracic ratio was 0.58 +/- 0.07. Most patients were in atrial fibrillation. Ninety-seven per cent of patients were followed-up by questionnaires. The results were expressed with respect to simple clinical events used in all previously reported series. The long-term mortality was identical in the 3 groups undergoing valve replacement (40 p. 100 at 7 years) but was much less in the group undergoing valvuloplasty (18 p. 100 at 7 years). The mortality rate due to valvular problems was significantly less in the valvuloplasty group (2 p. 100 at 7 years) than in the groups with mechanical prostheses (20 p. 100 at 7 years). Intermediate results were observed in the bioprosthetic group (9 p. 100 at 7 years). Thrombo-embolism was significantly less common in the groups undergoing valvuloplasty and bioprosthetic valve replacement (2 p. 100 and 6 p. 100 at 7 years) than in the group with Starr-Edwards and Björk prostheses (30 p. 100 and 32 p. 100 at 7 years).(ABSTRACT TRUNCATED AT 250 WORDS)

Comparative evaluation of mitral valve repair and replacement with Starr, Björk, and porcine valve prostheses.

Four hundred consecutive patients with isolated mitral valve disease who were operated on between 1974 and 1977 underwent long-term evaluation. In this group there were 100 valve repairs, 100 porcine valves, 100 Starr valves, and 100 Björk valves. There were no significant differences in the preoperative clinical conditions of the patients in the four groups. Cumulative follow-up was 2058 patient-years. We concluded from the data that mitral valve repair was associated with fewer valve-related complications than valve replacement. Thromboembolism was the most significant parameter with respect to determining long-term results of the use of the porcine, Starr, and Björk valve prostheses.