Comparative analysis of mechanical and biological prosthetic valves after isolated valve replacement--cooperative study on total 1281 patients
Nakano, S.; Kawashima, Y.; Komatsu, S.; Sakai, K.; Eguchi, S.; Aosaki, M.; Misaki, T.; Ohara, K.; Tokunaga, K.
Nihon Kyobu Geka Gakkai 37(3): 423-430
1989
ISSN/ISBN: 0369-4739 PMID: 2671191 Document Number: 343904
A total of 1281 patients (594 aortic and 687 mitral) received 734 mechanical valves (320 Bjork-Shiley, 283 SJM and 131 Omniscience) and 547 biological (259 ionescu-Shiley, 227 Hancock, and 61 Carpentier-Edwards) were analyzed for postoperative valve dysfunction and thromboembolism. The actuarial survival rates (free from late cardiac deaths and valve-related deaths) were 88.6% (11 years) for mechanical mitral and 86.0% (11 years) for biological mitral valves, and 91.7% (16 years) and 88.5% (12 years), for mechanical and biological aortic valves, respectively. There were no significant differences among these groups. Actuarial rates of freedom from valve-related events were 88.7% (11 years) and 51.7%, for mechanical and biological mitral valves. respectively. There was significantly difference between the two types of valves in over 7 years after surgery. In contrast, there were no significant differences between mechanical and biological aortic valves. Actuarial rates of freedom from valve dysfunction were 97.6% (11 years) for mechanical and 56.5%(12 years) for biological mitral valves. The net 12 year results showed no significant differences between the two types of mitral prosthetic valves, but a significantly increased rate of valve dysfunction in the biological mitral valves compared with the mechanical in over 6 years of the study. Concerning AVR, there were no significant differences in the incidence of valve dysfunction between mechanical and biological aortic valves. Actuarial rates of freedom thromboembolism were 92.3% (11 years) and 93.8% (11 years) for mechanical and biological mitral valves, respectively. There were no significant differences between the two types of mitral prosthetic valves. In contrast, a significantly low incidence of thromboembolism was demonstrated in the biological aortic valves compared with the mechanical aortic valves.