[Results of mitral-aortic valve replacements].

Seventy-five combined mitral and aortic valve replacements were done between 1970 and 1976 with a minimum follow-up of 12 months and a mean of 3.72 +/- 17 months using à Björk prosthesis in the aortic position and the Starr 6120 prosthesis in the mitral position. The early post-operative mortality was 5.3% and the late mortality 8.4%. The actuarial survival curve projected a mortality of 16% at 6 years, including the operative mortality. The survival at 6 years did not differ from that of mitral valve replacement alone during the same period, though it was less than the survival of aortic valve replacement for aortic regurgitation. Among the post-operative complications only 3 embolic complications were seen. Surprisingly, the degree of heart failure, the radiological heart size, and the haemodynamic data showed no satistically significant influence on the post-operative mortality. All of the survivors except one showed a functional improvement. Haemodynamic checks in 13 patients showed a significant reduction in mean pulmonary arterial pressure, in mean capillary wedge pressure and in arteriovenous oxygen difference, but not in the cardiac index. The radiological heart size was significantly reduced but this reduction was usually limited.