The ultimate prognosis after valve replacement: an assessment at twenty years.

摘要: Abstract Our experience over a 20-year period consists of 2,135 patients with initial caged-ball valve replacement: 52% aortic, 34% mitral, 12% double, and 2% triple-valve replacements, 59.2, 39.8, 10.3, 2.7 patient-centuries follow-up, respectively. Fifteen-year actuarial survival (± standard error) was 43 ± for aortic 44 3% mitral replacement, 27 5% double-valve 23 7% replacement. Restricting attention to operated on since 1973 divides the series almost in half does not dramatically improve 5-year (from 66 71 from 70 78 replacement respectively). There some alteration causes late death: largest percentage deaths both earlier current groups, 52%, cardiac related whereas only 24% 13%, respectively, were related. Over past two decades operative mortality has declined and, lesser extent, after improved. The incidence embolism decreased significantly, most notably Silastic ball valves. Dramatic improvements results will occur primarily by modifying cardiac-related death rate through operation medical management postoperative arrhythmias congestive heart failure.