title: Early and late results of aortic valve replacement. A series of 510 patients.
abstract: Aortic valve replacement was performed in 510 patients (Björk-Shiley valves in 93%), with concomitant surgical procedures in 146 cases. The patients were grouped according to technique of myocardial protection: Group I (n = 98) selective coronary perfusion, group II (n = 82) topical cooling, and group III (n = 330) cold crystalloid cardioplegia and topical cooling. The early mortality rate was 5.7% overall: Among patients with isolated aortic valve replacement in groups I, II and III it was 8.4, 1.7 and 1.3%, respectively, and among those with additional surgery 40.0, 12.5 and 8.4%. Myocardial infarction and low cardiac output were responsible for 65.5% of the early deaths. Follow-up ranged from 2 months to 16 11/12 years, totalling 2,859 patient years. In patients with isolated aortic valve replacement and Björk-Shiley prosthesis, the incidence of valve-related late complications/100 patient years was 0.49 for thromboembolism, 0.82 for anticoagulant-related haemorrhage and 0.49 for prosthetic valve endocarditis. There was no thrombotic encapsulation in aortic position. Survival at 5 and 10 years was 83% and 72%. Aortic valve replacement is a safe procedure and concomitant operations do not unreasonably increase risks.
authors.affiliation: Department of Surgery, University Central Hospital, Turku, Finland.
authors.forename: M J
authors.initials: MJ
authors.lastname: Janatuinen
authors.forename: E A
authors.initials: EA
authors.lastname: Vänttinen
authors.forename: V
authors.initials: V
authors.lastname: Rantakokko
authors.forename: M V
authors.initials: MV
authors.lastname: Inberg
mesh_terms: D001021:Aortic Valve; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006324:Heart Arrest, Induced / Q000379:methods; D006349:Heart Valve Diseases / Q000601:surgery; D006350:Heart Valve Prosthesis / Q000009:adverse effects / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control; D011474:Prosthesis Design; D015996:Survival Rate; D013997:Time Factors