AI Article Synopsis
- The study followed 368 patients over six years after multiple prosthetic valve surgeries, showing improvement in physical activity with a decrease in mean functional class from 4.05 to 2.1.
- About 61% of patients achieved stable good results, although specific complications and other heart diseases were major reasons for instability, with 51% having no complications.
- The overall survival rate was 39.2% (including intraoperative mortality) and 59.3% long-term, with myocardial insufficiency significantly impacting survival, suggesting surgery should occur when patients are in functional class 3, or class 2 for those with aortic defects.
Article Abstract
The results of six-year follow-up of 368 patients after multiple prosthetic valve implantation (mitral and aortic prostheses in 173, mitral and tricuspid prostheses in 129, three prostheses in 36, mitral and aortic prostheses with tricuspid annuloplasty in 30) are reviewed. The mean functional class was 4.05 prior to the operation, and eventually declined to 2.1, being indicative of increased physical activity of the patients. Good results were stabilized in 61% of cases. Major causes of insufficient stability of good results were specific complications and progressive attendant heart diseases. There were no specific complications in 51% of the patients. The survival rate was 39.2%, including the intraoperative mortality rate. Long-term survival rate was 59.3%. Myocardial insufficiency, mostly occurring in patients with aortic prostheses and preoperative functional class 4 or 5, was one of the leading causes of reduced long-term survival. Therefore, patients should undergo surgery when in functional class 3, and those with aortic defects, while they are in functional class 2.
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