Long-term results of valve replacement with the Liliehei-Kaster and Omniscience tilting disc prostheses
Sasaki, S.; Ohzeki, M.; Inoue, T.; Asada, K.; Kishida, H.; Shiguma, S.; Kakimoto, S.; Maeda, M.; Takeuchi, A.
Nihon Kyobu Geka Gakkai 35(9): 1697-1704
1987
ISSN/ISBN: 0369-4739 PMID: 3429955 Document Number: 294511
From April 1976 to June 1984, 112 patients underwent valve replacement with the Lillehei-Kaster (L-K) or Omniscience (O-S) prosthesis: 62 patients had MVR (L-K 26, O-S 36) and 50 patients had AVR (L-K 21, O-S 29). Concomitant operative procedures were performed in 19 of the 62 MVRs (31%) and 19 of the 50 AVRs (38%), the operative mortality was 13% for MVR and 8% for AVR. The late mortality was 14.8% for MVR and 8.7% for AVR. The cummurative follow-up was 226 patients-years for MVR (range 2 months to 9 1/2 years, mean 4.2 years) and 230 patient-years for AVR (range 2 months to 9 1/2 years, mean 5 years). Actuarial survival rate at five years was 86% for MVR and 90% for AVR. The incidence of thromboembolism was 4.4% patient-year (systemic embolism 3.1, valve thrombosis 1.3) after MVR and 6.1% patient-year (systemic embolism 5.7, valve thrombosis 0.4) after AVR. Four patients with MVR (valve thrombosis 3, prosthetic valve endocarditis 1) and one with AVR underwent reoperations. The incidence of reoperation was 1.8% and 0.4%/patient-year respectively. Although the symptomatic improvement after valve replacement with those prostheses was compared favourably with those having other valves, we discontinued their clinical use because of the relatively high incidence of thromboembolism.