OBJECTIVE: The purpose of this study is to analyze the experience of the Heart Institute with the use of mechanical bileaflet prostheses. PATIENTS AND METHODS: Between June 1989 and August 1998, 323 mechanical bileaflet prostheses were implanted in 300 patients. Mean age was 38.7 ± 18.4 years. One hundred and ninety one (63.7%) patients were male. The ethiology was rheumatic fever in 161 (53.7%) patients. One hundred and eighty-six aortic valve replacements, 89 mitral replacements, 2 tricuspid replacements, 22 double mitral and aortic replacement and 1 mitral and tricuspid replacement were performed. Seventy -three (24.3%) patients were in NYHA functional class (FC) IV 165 (55.4%) in FC III and 61 (20.3%) in FC II. RESULTS: Hospital mortality was 9% (27 patients), 13.5% in the mitral group, 7.5% in the aortic group and 4.5% in double mitral and aortic. The linearized rates in the late postoperative period were: 0.3% patient-year for endocarditis, 0.3% patient-year for leak, 0.2% patient-year for hemorrhage and 1.0% patient-year for thromboembolism. In the late postoperative period 213 patients (91%) were in FC I, 16 (6.8%) in FC II, 4 (1.7%) in FC III and 1 (0.5%) in FC IV. The actuarial survival in 9 years was 68.1 ± 15.5% for the mitral group and 67.5 ± 10.8% for the aortic. CONCLUSIONS: In conclusion, the results of valve replacement with mechanical bileaflet prostheses were satisfactory.
Heart valve prosthesis implantation; Heart valve diseases; Heart valve prosthesis implantation
