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Abstract
In a total of 37 patients, one or more valves were replaced. In 18, the mitral valve
only was substituted; in 10, the aortic valve only; and in 3, the tricuspid valve
only. Double valve replacement was effected in 6 subjects.
All patients were severely disabled, many being totally incapacitated. Progressive
deterioration in function and failure to respond to medical therapy was the indication
for surgery.
The techniques used are described, the major requirements being adequate total-body
perfusion and careful protection of the myocardium during bypass.
There were 9 deaths (immediate and late) in this series. Complete correction of all
significant valve defects at one procedure is essential for a successful surgical
outcome. Bacterial endocarditis is the major postoperative complication.
The response to surgery was most rewarding with return of desperately ill patients
to almost normal health. The major long-term problem was the occurrence of small emboli
which manifested as transient cerebral episodes.
Preliminary investigations have shown very satisfactory function of the aortic prosthesis
at rest and on effort. The mitral prosthesis is less efficient at rapid heart rates
and has been modified. The tricuspid prosthesis is the least efficient of the three.
Some of the problems of valve prostheses have been discussed. Further study and more
experience are necessary before a perfect prosthesis can be developed. At the present
time, the U.C.T. prostheses can be inserted at low operative risk, function adequately
once inserted, and will continue to function satisfactorily for long periods of time.
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References
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Article info
Publication history
Received:
May 29,
1964
Identification
Copyright
© 1965 Published by Elsevier Inc.
