J.Jpn. Surg. Soc.. 93(6): 639-645, 1992

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Original article

LONG-TERM CLINICAL RESULTS AFTER AORTIC VALVE REPLACEMENT WITH MECHANICAL HEART VALVES AND MITRAL VALVE REPLACEMENT WITH PORCINE VALVES

Long-term clinical results of aortic valve replacement (AVR) with mechanical heart valves and mitral valve replacement (MVR) with porcine valves were analysed. Sixty-three patients received isolated AVR and 48 received isolated MVR. Sixty-eight patients with MVR including double or triple valve replacement were also added in order to evaluate the primary tissue failure (PTF). The patients with operative deaths were excluded. Survival rate at 11 years in AVR was 68±10％ and 67±15％ in MVR without statistical difference. At 11 years, 76±8％ of the patients in AVR were free from valve-related complications in contrast with the poor result of 34±31％ in MVR (p＜0.01). Main cause of this poor result in MVR was PTF as indicated in following event free rates；83±9％ at 7 years, 61±25％ at 10 years and 49±31％ at 13 years. There was no statistical difference between patients of above 50 years and below 49 years in PTF. Valve-related death event free was 93±5％ in AVR and 86±11％ in MVR at 11 years (not significant), however, there was statistical difference in re-operatin event free rate as 94±5％ in AVR and 76±11％ in MVR at 11 years（p＜0.001）. These results suggest that the use of porcine valves in mitral position is confined to the selected patients.

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