Early-phase events with the mitroflow pericardial valve.
From January 1986 to January 1987, 116 Mitroflow pericardial valves were implanted in 98 patients at our center. Ages ranged from 10 to 83 years (mean, 64.9 years). Forty-three patients (44%) were in New York Heart Association Functional Class III or IV at the time of surgery. Twelve patients (12%) had undergone prior cardiac surgery. Ten hospital deaths (10%) (70% Confidence Limits, 7% to 14%) occurred. Incremental risk factors for hospital death included female gender (p = 0.08), higher functional class preoperatively (p = 0.04), and longer cardiopulmonary bypass time (p = 0.05). All 88 hospital survivors (100%) were followed for 6 to 13 months (mean, 9 months) after repair. Two late deaths (2.3%) occurred: 1 at 1.5 months from subacute cardiac failure, and another at 5 months from non-valve-related sepsis. Actuarial survival at 15 months was 87% +/- 5.5%. No late reoperations were performed. One patient who exhibited mild mitral incompetence 4 months postoperatively is being followed closely. Two patients (2.3%) who were not on anticoagulant therapy developed thromboembolic events in association with chronic atrial fibrillation. No patient has had hemolysis or infective endocarditis. All patients are now in Functional Class I or II. Our early-phase assessment of this valve reveals a low risk of valve-related events. Its low-profile frame and wide, flexible sewing ring make this prosthesis technically satisfactory for implantation. Continuing close follow-up will determine intermediate-and late-phase hazards.
McGrath
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Department of Surgery, Deborah Heart and Lung Center, and the Deborah Research Institute, Browns Mills, New Jersey, USA.
Gonzalez-Lavin
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