Early Results after Combined Aortic and Mitral Valve Replacement with theConvexo-ConcaveBjörk-Shiley Prosthesis

This paper reports the early results of combined aortic and mitral valve replacement in 39 patients, who underwent operation with the convexo-concave Björk-Shiley prosthesis. There were no intra-operative deaths. Two patients (5%) died while in hospital of myocardial failure and left ventricular rupture, respectively. One late death (3%) was due to a thrombosis of the mitral prosthesis (N.Y.H.A. class IV at operation). Cumulative follow-up (2-31 months) was 100%. One patient had radial artery embolization while converting to atrial fibrillation. Another patient required repair of an aortic paraprosthetic leakage. Clinical improvement (N.Y.H.A.) was noted in 15/19 re-examined patients (79%). Average heart volume decreased (p less than 0.05) and Maximal working capacity increased (p less than 0.05) after valve replacement. Seven patients (7/19) converted to sinus rhythm after operations and one (1/19) developed atrial arrhythmia. Haemolysis was generally mild and without signs of anaemia. The overall thrombo-embolic rate (5.9% per year) remained thus far the same as that encountered with the standard model prosthesis in combined aortic and mitral valvular disease.