Clinical Results of Double Mitral and Aortic Valve Replacement

승모판과 대동맥판의 중복치환수술의 임상적 평가

One-hundred-and-seven patients were the consecutive cases of double replacement of the mitral and the aortic valves at the same time using the lonescu-Shiley bovine pericardial xenograft valve during the period between May, 1979 and June, 1984. They were 64 males and 43 females, and their ages ranged from 13 to 62 years [mean age, 34.011.9 years]. Eight patients died within 30 days after surgery [operative mortality rate, 7.5%], and 7 others thereafter [late mortality rate, 6.5%; or 4.21%/patient-year]. Ninety-nine early survivors were followed up for a total duration of 166.1 patient-years [mean duration, 20.116.1 months]. Two patients experienced thromboembolic complication with no death [1.20%/patient-year]; five developed prosthetic valve endocarditis [3.01%/patient-year] with one death; and three had a new development of aortic regurgitant murmur and they were, along with a mortality from endocarditis, classified into the cases of tissue valve failure [2.41%/patient-year]. The actuarial survival rate including the operative mortality was 82.24.7% at 6 years after surgery. The probabilities of freedom from thromboembolism and from valve failure were 97.61.7% and 88.67.6% at 6 years respectively. Symptomatic improvement was excellent in most of the cases at the follow-up end, showing the mean of the postoperative NYHA Classes of 1.120.33 from the preoperative one of 2.860.54. These results compares favorably with the ones reported from the major institutions. Clinical results of isolated replacement of the mitral valve and of the aortic valve were previously reported. The clinical results of a total and consecutive patients with replacement of single mitral and single aortic and double mitral and aortic valves on the mortality rate, survival rate, complication frequency, and symptomatic improvement all fully stands for the good therapeutic modalities of the valvular heart diseases with severely damaged lesions.