Aortic valve replacement. A randomized study comparing the Björk-Shiley and Lillehei-Kaster disc valves. Long-term results.
Three hundred patients were selected at random in order to compare the Björk-Shiley (B-S) and Lillehei-Kaster (L-K) valves in the aortic position. The mean follow-up time was 4 3/4 years (range 3 1/4-7 years). There were 15 late deaths in the B-S group and 23 in the L-K group. The incidence of sudden and unexpected deaths was much higher in the L-K than in the B-S group (10:1). The 7-year actuarial survival rate was 82% in the B-S and 76% in the L-K group. In both groups the survival rate was higher in patients with large valves than in those with small valves; in the L-K group this difference was significant (p less than 0.02). The overall thrombo-embolic rate was 3.2 per 100 patient years in the B-S and 2.8 in the L-K group. Valve thrombosis occurred in 3 patients with B-S valves and in 4 with L-K vales. One of the L-K valves was thrombosed early after operation due to faulty suture technique. Of the long-term survivors of working age 80% in the B-S and 70% in the L-K group returned to work. There was a close correlation between functional capacity (NYHA) and the employment rate.
D001021:Aortic Valve / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000601:surgery; D002543:Cerebral Hemorrhage / Q000209:etiology; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis / Q000295:instrumentation*; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011897:Random Allocation; D013923:Thromboembolism / Q000209:etiology