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Late follow-up of 291 patients who underwent heart valve replacement with mechanical valves

Between January 1980 and December 1993, 291 patients underwent valve replacement with mechanical valves in the Heart Institute of HCFMUSP. One hundred and eighty seven (64.3%) patients were male, aged between 2 months and 78 years (average 38.3 +/-18.5). The ethiology was rheumatic in 132 patients (45.4%). Were inserted 315 mechanical valves, 201 aortic, 77 mitral, 15 double aortic-mitral, 2 tricuspid, 1 double mitral-tricuspid, and 1 triple mitral-aortic-tricuspid. There were associated procedures in 164 patients (56.4%), the most frequent was replacement of ascending aorta in 49 (16.8%). One hundred and forty one patients (48.4%) underwent previous heart valve surgery. Follow-up data are reported concerning functional status (NYHA) and valve related complications. Early mortality rate was 12.4% (36 patients). Followup totaled 10078 months/patient (159 patients), with a mean follow-up period of 40.6 months. The linearized rates of thromboembolism, hemorrhage related to antithrombotic therapy, late death, endocarditis, paravalvular leak and hemolysis were 1.33%, 0.95%, 1.9%, 0.19%, 0.57% and 0.57% patients/year, respectively. Fourteen year survival rate was 63.8%. Eighty two percent of the patients were in functional class I in the postoperative period. It was possible to conclude that the patients submitted to mechanical valve replacement had a satisfactory clinical evolution.

Heart valves prostheses; Heart valves prostheses; Heart valves


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