Cor Vasa 2003, 44(7-8):351-356

Mid-term results with the Sorin Allcarbon mechanical prosthesis in the mitral position

Michael Jonák^1,*, František Straka¹, Věra Lánská², Petr Pavel¹, Vilém Rohn¹, Ivo Skalský¹, Jan Pirk¹

¹ Klinika kardiovaskulární chirurgie

² Oddělení statistiky, Institut klinické a experimentální medicíny, Praha, Česká republika

Aim of the study:
The outcome of patients undergoing mitral valve replacement using a Sorin Allcarbon prosthesis was evaluated as part of early and mid-term clinical follow-up. In addition, the hemodynamic function of the implanted prosthesis was assessed in detail using Doppler echocardiography.

Material and methods:
In the 1996-1999 period, a total of 216 patients (138 women, 78 men, mean age 59.3 ± 8.3 years) had a Sorin Allcarbon mitral valve prosthesis implanted in our department. Follow-up was 100% complete and reached 349 patient-years (pt-yrs), with a mean follow-up time of 1.6 years (6 months to 4.1 years). Doppler echocardiography was performed in 178 patients during follow-up outpatient visits.

Results:
Early (30-day) postoperative mortality was 6.48% (14/216). Previous mitral valve surgery (p < 0.05), coronary artery disease (CAD) (p < 0.02), and pulmonary vascular resistance > 5 W. u. (p < 0.02) significantly increased the risk of early death. A preoperative NYHA Class IV, history of heart failure, a prolonged clamp and extracorporeal circulation also increased the risk of early mortality, but not within the predefined 5% limit of significance. Another 18 patients, i. e., a total of 32/216, died during clinical follow-up. One- and three-year survival rates were 89.3 ± 2.1% (n = 151) and 79.4 ± 3.9% (n = 19). After one year, 92.7 ± 1.9% (n = 109) patients were free of valve-related complications; the respective figures for two and three years after the operation were 84.1 ± 3.1% (n = 42) and 80.1 ± 4.0% (n = 11). Among preoperative parameters, CAD (p < 0.02), chronic obstructive pulmonary disease (p < 0.05), and stroke (p = 0.05) have a significantly adverse effect on the mid-term survival. The values measured using Doppler echocardiography show excellent hemodynamic properties of the prosthesis.

Conclusion:
Early and mid-term mortality, the incidence of postoperative complications and the percentage of valve-related complications are low and fully comparable with the results obtained with other valve prostheses.

Keywords: Mitral valve replacement; Sorin Allcarbon; Mid-term follow-up

Published: July 1, 2003  Show citation