The ultimate prognosis after valve replacement: An assessment at twenty years

J. F. Teply, G. L. Grunkemeier, H. D'Arcy Sutherland, L. E. Lambert, V. A. Johnson, Albert Starr

Research output: Contribution to journalArticle

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Abstract

Our experience over a 20-year period consists of 2,135 patients with initial caged-ball valve replacement: 52% aortic, 34% mitral, 12% double, and 2% triple-valve replacements, with 59.2, 39.8, and 2.7 patient-centuries of follow-up, respectively. Fifteen-year actuarial survival (± standard error) was 43 ± 2% for aortic and 44 ± 3% for mitral valve replacement, and 27 ± 5% for double-valve and 23 ± 7% for triple-valve replacement. Restricting attention to patients operated on since 1973 divides the series almost in half and does not dramatically improve the 5-year actuarial survival (from 66 ± 2% to 71 ± 3% and from 70 ± 2% to 78 ± 3% for aortic valve replacement and mitral valve replacement, respectively). There was some alteration in the causes of late death: the largest percentage of deaths in both the earlier and current groups, 52%, was cardiac related whereas only 24% and 13%, respectively, were valve related. Over the past two decades operative mortality has declined and, to a lesser extent, late survival after mitral valve replacement has improved. The incidence of embolism has decreased significantly, most notably with the Silastic ball valves. Dramatic improvements in late results will occur primarily by modifying the cardiac-related death rate through earlier operation and improvements in the medical management of postoperative arrhythmias and congestive heart failure.

Original languageEnglish (US)
Pages (from-to)111-119
Number of pages9
JournalAnnals of Thoracic Surgery
Volume32
Issue number2
DOIs
StatePublished - 1981

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Mitral Valve
Survival
Mortality
Embolism
Aortic Valve
Cardiac Arrhythmias
Cause of Death
Heart Failure
Incidence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Teply, J. F., Grunkemeier, G. L., D'Arcy Sutherland, H., Lambert, L. E., Johnson, V. A., & Starr, A. (1981). The ultimate prognosis after valve replacement: An assessment at twenty years. Annals of Thoracic Surgery, 32(2), 111-119. https://doi.org/10.1016/S0003-4975(10)61017-X

The ultimate prognosis after valve replacement : An assessment at twenty years. / Teply, J. F.; Grunkemeier, G. L.; D'Arcy Sutherland, H.; Lambert, L. E.; Johnson, V. A.; Starr, Albert.

In: Annals of Thoracic Surgery, Vol. 32, No. 2, 1981, p. 111-119.

Research output: Contribution to journalArticle

Teply, JF, Grunkemeier, GL, D'Arcy Sutherland, H, Lambert, LE, Johnson, VA & Starr, A 1981, 'The ultimate prognosis after valve replacement: An assessment at twenty years', Annals of Thoracic Surgery, vol. 32, no. 2, pp. 111-119. https://doi.org/10.1016/S0003-4975(10)61017-X
Teply JF, Grunkemeier GL, D'Arcy Sutherland H, Lambert LE, Johnson VA, Starr A. The ultimate prognosis after valve replacement: An assessment at twenty years. Annals of Thoracic Surgery. 1981;32(2):111-119. https://doi.org/10.1016/S0003-4975(10)61017-X
Teply, J. F. ; Grunkemeier, G. L. ; D'Arcy Sutherland, H. ; Lambert, L. E. ; Johnson, V. A. ; Starr, Albert. / The ultimate prognosis after valve replacement : An assessment at twenty years. In: Annals of Thoracic Surgery. 1981 ; Vol. 32, No. 2. pp. 111-119.
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