PORCINE MITRAL STENTLESS VALVE MIDTERM CLINICAL-RESULTS

Objectives: Time testing is essential with any valvular procedure, esp ecially when a new concept is introduced such as the mitral stentless valve. Our purpose is to evaluate the results obtained over 4 years wi th this operation, particularly to attest the impact of preservation o f annulo ventricular continuity on the long term results of these pati ents. Methods: From March 1992 to August 1996, 120 patients had their mitral valves replaced with a porcine stentless mitral valve. The obse rvation period was 54 months with total patients follow-up of 3424 mon ths with a mean of 28.5 months. The age ranged from 11 to 72 years (me an 35.22 +/- 14.98). There were 73 females (60.8%) and 47 males (39.2% ). The predominant etiology was rheumatic heart disease. Associated pr ocedures were performed In 12 patients (10%), and the great majority o f the patients were in functional class III and IV (NYHA). Results: Ho spital mortality occurred in seven patients (5.83%) non valve related except for one early case of endocarditis. Early reoperation related t o technical failure were necessary in 4 patients without mortality. Fo llow-up was accomplished in 101 patients and ranged from 2 to 54 month s, Late reoperations were required in 16 patients (nine due to mitral insufficiency, five because of endocarditis and two for mitral stenosi s), Most reoperations were related to technical failure. Among the 82 patients presently in control, 72 showed a competent mitral stentless valve, eight with stable mild mitral regurgitation and in two a decrea sed mitral orifice. Hemodynamic performance of the valve has been exce llent in this group, particularly in patients with left ventricular dy sfunction. Conclusion: Although technical complexity remains the main cause of reoperations with this valve, experience has shown that it no t only provides preservation of the left ventricular function hut also promised significant increase of the ejection fraction in patients wi th poor left ventricular function. (C) 1997 Elsevier Science B.V.