title: A 4-year experience with the Björk-Shiley Monostrut valve.
abstract: We reviewed 314 consecutive patients in whom a Björk-Shiley Monostrut aortic valve prosthesis was inserted by our cardiothoracic surgical unit from June 1982 through June 1986. The group comprised 220 males (70%) and 94 females (30%), with a mean age of 60 years (range, 5 to 83 years). Two hundred ninety-six patients (94%) received an aortic prosthesis alone, and the other 18 (6%) received both an aortic Monostrut valve and a Starr-Edwards mitral valve prosthesis. In each case, preoperative data were collected prospectively, and a questionnaire was sent at the time of follow-up. The median follow-up period was 23 months (range, 0 to 46 months); 6 (2%) of the patients were lost to follow-up. In the remaining 308 cases, there were 20 deaths (6.5%), 8 of which occurred within approximately 1 month after operation. There were no known instances of valve failure. One death occurred in the group that underwent double-valve replacement. Valve endocarditis accounted for 2 late deaths. With respect to preoperative dyspnea, 59 (19%) of the patients were in New York Heart Association functional Class I, 74 (24%) were in Class II, 138 (45%) were in Class III, and 37 (12%) were in Class IV. Postoperatively, there were 247 patients (80%) in Class I, 43 (14%) in Class II, 15 (5%) in Class III, and 3 (1%) in Class IV (p < 0.0001). All of the patients received postoperative anticoagulant therapy; 3.4% per year were subsequently readmitted for bleeding problems. Thromboembolic events necessitating hospitalization occurred in 3.0% of the patients per year. On the basis of these results, our early experience with the Björk-Shiley Monostrut valve in the aortic position has been satisfactory, with an acceptable rate of complications and no documented valve failures.
authors.affiliation: The Cardio-Thoracic Surgical Unit, Royal Adelaide Hospital, Adelaide, South Australia.
authors.forename: G
authors.initials: G
authors.lastname: Maddern
authors.forename: H S
authors.initials: HS
authors.lastname: Paterson
authors.forename: D R
authors.initials: DR
authors.lastname: Craddock
authors.forename: I K
authors.initials: IK
authors.lastname: Ross
authors.forename: J
authors.initials: J
authors.lastname: Stubberfield
authors.forename: S
authors.initials: S
authors.lastname: Picozzi
authors.forename: P B
authors.initials: PB
authors.lastname: Leppard