[Comparison of long-term clinical results of the three models of the Björk-Shiley valve prosthesis and the Omnicarbon valve prosthesis].
A multi-institutional cooperative study, that was a comparison of long-term results of the replacement of the four models of the oblique disc valve prosthesis which had been implanted on aortic and mitral position alone or double from December 1976 to September 1992 in the eight national hospitals in Japan was performed. Seven hundred and thirty-four patients and 765 prostheses that consisted of 582 patients and 610 prostheses of the Björk-Shiley (BS) valve, including 326 patients of the Spherical disc (SP) valve (49 aortic, 259 mitral, and 18 double aortic-mitral), 103 patients of the Convexoconcave disc (CC) valve (45, 51, 7) and 153 patients of the Monostrut (MS) valve (101, 49, 3), and of 152 patients (71, 78, 3) and 155 prostheses of the Omnicarbon (OC) valve were compared with their mortality and morbidity in every valve position respectively according to the approval by STS-guideline. The MS valve and the OC valve showed 0% to 11.3% of operative mortality, 0.3%/py to 1.8%/py of valve related mortality, 85.5% +/- 5.6% to 98.4% +/- 1.6% of actuarial survival rate at 10 years, and 58.5% +/- 6.4% to 82.7% +/- 5.7% of actuarial free rate of all mortality and morbidity at 10 years in every valve position. Structural deteriorations occurred in two patients of the CC valve in the mitral position only, and its rate of all valve positions showed 0.04%/py. Significant differences were seen in actuarial survival rate at 10 years after aortic valve replacement, and in operative mortality rate, improved degree of NYHA class, structural deterioration rate and actuarial free rate of all mortality and morbidity after mitral valve replacement between the group of the MS and OC valve and the group of the SP and CC valve. Therefore the MS valve or the OC valve should be selected to implant rather than the SP valve or the CC valve, and the patient who had been implanted with the CC valve should be treated considering valve position, valve position, valve size, age and activity of the patient and the manufactured date of the prosthesis.
Department of Cardiovascular Surgery, National Hospitals of Hakodate, Sendai, Japan.
S
S
Ohta
M
M
Ohuchi
K
K
Katsumoto
Y
Y
Hosoi
N
N
Kitamura
M
M
Tanizaki
K
K
Ihara
S
S
Sumida
D001705:Bioprosthesis / Q000401:mortality*; D005260:Female; D006349:Heart Valve Diseases / Q000601:surgery; D006350:Heart Valve Prosthesis / Q000379:methods / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate