Performance of the Ionescu-Shiley pericardial valve in the aortic position: 100 months clinical experience.
From August 1977 through August 1984, 239 patients underwent aortic valve replacement (AVR) with the Ionescu-Shiley pericardial valve. Isolated AVR was performed in 112 patients and associated cardiac surgery in 127 patients (53.1%). One hundred twenty-eight patients were males and 111 females, with an average age of 50.6 years (range 15 to 78 years). There were 24 hospital deaths (10%) and 15 late deaths (8.9%). The expected 100 months survival rate was 82.8 +/- 5.5 (91.3 +/- 5.6% for isolated AVR, and 75 +/- 7.8% for associated AVR). All patients were postoperatively studied until December 1985. The cumulative duration of follow-up was 894.08 patient-years, with a mean follow-up of 44.9 months per patient. There were 10 thromboembolic episodes in this series (3 peripheral and 7 central), with a linearized incidence of 1.1% per patient-year. The actuarial projection of freedom from thromboembolic episodes at 100 months follow-up was 94.4 +/- 3.4% (96.9 +/- 2.2% for isolated AVR, and 92.6 +/- 3.9% for associated AVR). Twenty-five patients required reoperation (2.79% per patient-year): 6 for infective endocarditis, 3 for paravalvular leak, one for valve thrombosis, 3 for another valve explantation, and 12 for primary tissue failure (1.3% per patient-year). In conclusion, the Ionescu-Shiley valve has a satisfactory performance in the aortic position at long-term follow-up. In our experience, the higher rate of postoperative complications occurred among patients with concomitant cardiac surgery, so not necessarily related to this pericardial valve.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000601:surgery; D001705:Bioprosthesis / Q000009:adverse effects; D004697:Endocarditis, Bacterial / Q000401:mortality / Q000601:surgery; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000151:congenital / Q000401:mortality / Q000601:surgery; D006350:Heart Valve Prosthesis / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012086:Reoperation; D012214:Rheumatic Heart Disease / Q000401:mortality / Q000601:surgery; D013923:Thromboembolism / Q000453:epidemiology