LATE POSTOPERA-TIVE OUTCOME AFTER AORTIC VALVE REPLACEMENT USING TILTING DISC VALVE OR BILEAF-LET VALVE

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Late postoperative outcome of aortic prosthetic valves, which was implanted between March 1976 and March 1993, were reviewed. A linealized rate of thromboembolic event was 0.61, 0.60, 0.54, 0.42%/pt·Y in patients with Björk-Shiley spherical disc, Lillehei-Kaster, Omniscience, St.Jude Medical prosthetic valve, respectively. Thrombosed valve occurred frequently in Omnisci-ence valve (1.62%/pt·Y) . Among those prosthetic models, there were no significant differences in linealized rate of anticoagulation-related hemorrhage, prosthetic valve endocarditis and prosthesis-re-lated death including sudden death. Actuarial survival rate at 10 years postoperatively were 94.2% in St.Jude Medical, 88.3% in Omniscience, 76.7% in Björk-Shiley and 66.7% in Lillehei-Kaster prosthetic valve. In patients with Duromedics valve there was no postoperative complications, and the survival rate was 94.7% at 8 years postoperatively. In patients with St.Jude Medical (Teflon sewing cuff) and Björk-Shiley monostrut prosthesis, no signs of intravascualr hemolysis were seen, and the level of lac-tate dehydrogenase were allowable. Carbomedics valve was successfully implanted in 8 patients with narrow aortic ring, subvalvular patch repair and annuloaortic ectasia. ‹Conclusion› (1) In the pre-sent series, bileaflet valves were demonstrated to be superior to tilting disc valves in antithrom-bogenicity. (2) In selective cases, Björk-Shiley monostrut valve, St.Jude Medical with Teflon cuff and Carbomedics were considered to be useful alternative.

LATE POSTOPERA-TIVE OUTCOME AFTER AORTIC VALVE REPLACEMENT USING TILTING DISC VALVE OR BILEAF-LET VALVE

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