Results of 300 Bileaflet Mechanical Valve Implanatations

Abstract

Three hundred bileaflet mitral or aortic mechanical prosthetic heart valves were implanted in 250 patients over a four-year period at Kosuyolu Heart and Research Center: 96 patients underwent mitral valve replacement (MVR), 81 aortic valve replacement (AVR), and 73 AVR + MVR. Seven of the mitral, 8 of the aortic, and 2 of the double valve replacements involved additional cardiac proce dures. Sex ratio was 63% females, 37% males. The youngest patient was nine, the oldest was seventy-six, and the average age was thirty-nine years; 59% of the patients had atrial fibrillation, 66% were in NYHA functional Class III-IV, and 61% were in congestive heart failure.

Hospital mortality was 9.6% and late mortality was 4%. The predictors of survival were evaluated. Preoperatively and postoperatively 17 variables were studied by statistical analysis. Factors identified as influencing survival were: female sex, advanced age, NYHA Class more than III, increased cardiothoracic ratio, congestive heart failure, diabetes mellitus, giant left atrium, and prosthet ic valve endocarditis. Eleven patients developed endocarditis, and 21 had throm boembolic episodes.

The authors conclude that the bileaflet mechanical prosthetic heart valve is a good candidate for mechanical valve replacement among the currently availa ble choices.