This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bloomfield, P. Articles by Miller, H. C. Search for Related Content PubMed PubMed Citation Articles by Bloomfield, P. Articles by Miller, H. C.

Circulation, Vol 73, 1213-1222, Copyright © 1986 by American Heart Association

ARTICLES

A prospective evaluation of the Bjork-Shiley, Hancock, and Carpentier- Edwards heart valve prostheses

P Bloomfield, AH Kitchin, DJ Wheatley, PR Walbaum, W Lutz and HC Miller

From 1975 to 1979, 540 patients undergoing valve replacement were entered into a randomized trial and received either a Bjork-Shiley (273 patients) or a porcine heterograft prosthesis (initially a Hancock valve [107 patients] and later a Carpentier-Edwards prosthesis [160 patients]). Two hundred and sixty-two patients required mitral valve replacement, 210 required aortic valve replacement, 60 required mitral and aortic valve replacement, and eight also required associated tricuspid valve replacement (six mitral valve replacement; two mitral plus aortic valve replacement). Analysis of 34 preoperative and operative variables showed the treatment groups to be well randomized. In-hospital mortality was not significantly different among patients receiving the three prostheses for aortic valve replacement (7.6% overall) and mitral plus aortic valve replacement (10% overall), but there was a higher in-hospital mortality for patients undergoing mitral valve replacement with the Carpentier-Edwards prosthesis (15.5% compared with 8.8% overall; p = .03). This difference could not be explained on the basis of any preoperative or operative variable. Median follow-up was 5.6 (range 2.8 to 8.3) years. Actuarial survival after mitral valve replacement was 56.7 +/- 7.0% at 7 years, that after aortic valve replacement was 69.6 +/- 9.6% at 7 years, and that after mitral plus aortic valve replacement was 62.5 +/- 20.0% at 7 years. There was no significant difference in actuarial survival of patients receiving the three prostheses within the mitral, aortic, and mitral plus aortic valve replacement groups, nor was there a difference when these groups were amalgamated. Thirty-seven patients required reoperation for valve failure (15 with Bjork-Shiley, 12 with Hancock, and 10 with Carpentier-Edwards valves; p = NS) and 11 died at reoperation (four with Bjork-Shiley, four with Hancock, and three with Carpentier-Edwards valves; overall operative mortality 29.7%). Up to 7 years after surgery, there was no significant difference in the incidence of thromboembolism in patients with different prostheses undergoing mitral or aortic valve replacement. There were too few patients undergoing mitral plus aortic valve replacement for meaningful comparison. There was no significant beneficial effect of anticoagulants in patients undergoing mitral or aortic valve replacement with porcine prostheses, but patients were not randomly allocated to anticoagulant treatment. All patients with Bjork-Shiley prostheses received anticoagulants.(ABSTRACT TRUNCATED AT 400 WORDS)

This article has been cited by other articles:

				A. Colli, J.-P. Verhoye, A. Leguerrier, and T. Gherli Anticoagulation or antiplatelet therapy of bioprosthetic heart valves recipients: an unresolved issue Eur. J. Cardiothorac. Surg., April 1, 2007; 31(4): 573 - 577. [Abstract] [Full Text] [PDF]

				T. Gherli, A. Colli, C. Fragnito, F. Nicolini, B. Borrello, S. Saccani, R. D'Amico, and C. Beghi Comparing Warfarin With Aspirin After Biological Aortic Valve Replacement: A Prospective Study Circulation, August 3, 2004; 110(5): 496 - 500. [Abstract] [Full Text] [PDF]

				H Oxenham, P Bloomfield, D J Wheatley, R J Lee, J Cunningham, R J Prescott, and H C Miller Twenty year comparison of a Bjork-Shiley mechanical heart valve with porcine bioprostheses Heart, July 1, 2003; 89(7): 715 - 721. [Abstract] [Full Text] [PDF]

				Y.-Y. Cen, D. D. Glower, K. Landolfo, J. E. Lowe, R. D. Davis, W. G. Wolfe, C. Pieper, and B. Peterson Comparison of survival after mitral valve replacement with biologic and mechanical valves in 1139 patients J. Thorac. Cardiovasc. Surg., September 1, 2001; 122(3): 569 - 577. [Abstract] [Full Text] [PDF]

				S. S. Khan, A. Trento, M. DeRobertis, R. M. Kass, M. Sandhu, L. S. C. Czer, C. Blanche, S. Raissi, G. P. Fontana, W. Cheng, et al. Twenty-year comparison of tissue and mechanical valve replacement J. Thorac. Cardiovasc. Surg., August 1, 2001; 122(2): 257 - 269. [Abstract] [Full Text] [PDF]

				B. G. Barratt-Boyes, W. M. Jaffe, and R. M. Whitlock THE MEDTRONIC INTACT* PORCINE VALVE: TEN-YEAR CLINICAL REVIEW J. Thorac. Cardiovasc. Surg., December 1, 1998; 116(6): 1005 - 1014. [Abstract] [Full Text] [PDF]

				C. E.E. Kuntze, E. H. Blackstone, and T. Ebels Thromboembolism and mechanical heart valves: a randomized study revisited Ann. Thorac. Surg., July 1, 1998; 66(1): 101 - 107. [Abstract] [Full Text] [PDF]