LONG-TERM CLINICAL-PERFORMANCE OF SORIN TILTING-DISC MECHANICAL PROSTHESES IN THE MITRAL AND AORTIC POSITION

Objective. Analyzing the long term performance of Sorin tilting-disc m echanical prostheses. Experimental design. Retrospective patient-orien ted study. The total follow-up was 460.2 patient-years. Follow-up data was obtained from the patients themselves or from their relatives. Se tting. Department of Cardiovascular Surgery in a general community hos pital.Patients. Seventy four patients undergoing valve replacement wit h Sorin tilting-disc mechanical prostheses between May, 1982 and July 1991. Interventions. Thirty one of those patients underwent isolated m itral valve replacement (MVR) and 43 isolated aortic valve replacement (AVR). Measures. The incidence of the different complications is expr essed as linearized rates. Actuarial analysis was performed with the K aplan-Meier method. Results, Linearized rates for MVR and AVR for the different complications (events per 100 patient-years) were, respectiv ely: Late mortality: 4.5+/-1.6 and 1.8+/-0.8; Thromboembolism: 3.4+/-1 .4 and 1.1+/-0.6; Anticoagulant-related hemorrhage: 2.8+/-1.3 and 0.3/-0.3; Prosthetic endocarditis: 1.1+/-0.8 and 0.7+/-0.5; Nonstructural dysfunction: 0.5+/-0.5 and 1.1+/-0.6; Reoperation: 1.1+/-0.8 and 0.3/-0.3. Actuarial probabilities of freedom from the different complicat ions were, respectively, at 13 years follow-up for MVR and 12 years fo llow-up for AVR, the following: Late mortality: 45.7+/-12.4% and 70.3/-7.9%; Thromboembolism: 74.6+/-10.8% and 90.7+/-5.1%; Anticoagulant-r elated hemorrhage: 79.4+/-11.6% and 97.3+/-2.7%; Prosthetic endocardit is: 92.7+/-4.9% and 91.2+/-6.4%; Non-structural dysfunction: 95.6+/-4. 3% and 88.2+/-6.6%; Reoperation: 83.6+/-11.8% and 97.3+/-2.7%. All val ve-related mortality and morbidity: 42.2+/-11.0% and 56.7+/-8.6%. Ther e was no instances of prosthetic structural failure. Conclusions. The Sorin mechanical prosthesis presents a good durability and its perform ance in the long term is comparable to other tilting-disc devices of t he same generation.