Late results of aortic valve replacement by prosthesis

During the 8 yr period from 1964 to December 1971, 144 consecutive patients with aortic valvular disease were subjected to aortic valve replacement by prosthesis. In addition, 26 of them suffered from mitral stenosis or insufficiency requiring mitral valve correction. 5 patients required replacement of the ascending aorta because of Marfan's syndrome as well as valve replacement. Hospital mortality (1 to 30 days after operation) was 14% and late mortality was 7%. Thromboembolism occurred in 17 patients (12%) and was fatal in 2. Since the introduction of the 2320 model of the Starr Edwards valve, 18 months ago, no thromboembolic complications have occurred. Postoperative hemolysis related to the prosthesis or residual aortic insufficiency was found in 12 patients, but only 1 required reoperation. The overall clinical and hemodynamic results have been gratifying in all except 3 patients. Of the 144 patients, 79% have survived for one to 8 yr following operation and the majority of patients have been rehabilitated.