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Long-term results after aortic valve replacement with the Mitroflow pericardial valve.

From September, 1986 through December, 1989, 121 patients underwent aortic valve replacement with the Mitroflow pericardial valve. There were 70 males (58%) and 51 females (42%), with an average age of 71 years (range 50-85 years). Reported here are the long-term results from these patients. Concomitant cardiac procedures were performed in addition to aortic valve replacement in 38 patients (31%); Coronary artery revascularization in 27 patients (22%); 4 patients (3%) had combination aortic/mitral valve replacement; mitral valve reconstruction in 4 patients (3%) and 3 patients (2%) had other additional procedures. Following surgery, standard postoperative examinations were performed every six month for 2 years; then yearly thereafter. At these times valvular function assessed echocardiographically. Current follow-up extends to 7 years (mean = 5 years) for surviving patients. Postoperative mortality for all observation period is as follows: Early deaths (> or =30 days postop) = 6 patients (5%), late death (>30 days) = 18 patients (15%). Valve-related causes of death included cerebral insult (thromboembolism) in two patients (one 10 months, other 15 months postoperatively). Postoperative valve-related morbidity included prosthetic endocarditis (1 patient) one year postoperatively; degenerative prosthetic failure (1 patient) 27 months postop; cusp tear (1 patient) with minimal hemodynamic changes after four years. In the patients with endocarditis and failure, a second successful operation corrected the problem. Also, in two patients antithrombolitic therapy related hemor-rhage occurred (one 9 months, the second 11 months postoperatively). This therapy was a result of atrial fibrillation, and we do not recommended it. In conclusion, we find that the Mitroflow pericardial heart valve gives adequate long-term results, especially in elderly patients with a small aortic ring, with very satisfactory quality of life.