Double valve replacement (n=282) yielded similar long-term outcomes to isolated mitral valve replacement (n=810), with identical early mortality and similar rates of late mortality.
Cohort (n=2,845)
Does double valve replacement have similar long-term clinical results compared to isolated mitral or aortic valve replacement?
Double valve replacement has similar long-term outcomes to isolated mitral valve replacement, justifying primary DVR in patients with severe mitral and borderline aortic valve disease to avoid secondary AVR.
The results after 282 consecutive double (aortic & mitral) valve replacements (DVR) are compared with our previously reported experience after mitral (MVR, n = 810) and aortic valve replacement (AVR, n = 1753). All but one patient received Björk-Shiley valves. The follow-up which closed on August 1, 1985 was 99.3% and covered 16,869 patient-years (mean 6.3 years/patient). Autopsies were performed in 74% of all fatalities. Early mortality rates were identical in the three patient groups, and late mortality did not differ between MVR and DVR patients. The fraction of valve-related mortality was similar in all groups. Anticoagulant-related bleeding was equally common in all patient groups. The incidences of thromboembolism, reoperation and valve failure did not differ between MVR and DVR patients, but were significantly higher than among AVR patients. With the exception of a slightly increased incidence of prosthetic valve endocarditis, the results after DVR equal those after MVR. In cases with severe mitral valve disease but borderline aortic valve disease, primary DVR is clearly justified and eliminates the need for, and risks of, a secondary AVR.
Lindblom et al. (Fri,) conducted a cohort in Aortic and mitral valve disease (n=2,845). Double (aortic and mitral) valve replacement vs. Isolated mitral valve replacement and isolated aortic valve replacement was evaluated on Mortality, thromboembolism, reoperation, and valve failure. Double valve replacement (n=282) yielded similar long-term outcomes to isolated mitral valve replacement (n=810), with identical early mortality and similar rates of late mortality.