[Long-term experience with multivalve replacement with the Medtronic-Hall mechanical prosthesis].

During the period from January to September 1986, 182 Medtronic-Hall (M-H) heart valve prostheses were implanted in 89 patients, mainly because of rheumatic valve disease (68.5%). The patients were divided in two groups. Group I consisted of 83 patients with aortic and mitral valve replacement. Six patients with tricuspid valve replacement plus aortic and/or mitral valve replacement constituted group II. In group I the majority of the patients (86.7%) were in functional class III or IV (NYHA). Twenty three patients had undergone at least one previous cardiac operation. Hospital mortality was 6.02% (5/83). In group II the patients were in functional class III or IV (NYHA). Hospital mortality was 33.3% (2/6). Death occurred in the operating room in only one instance. Follow-up was completed in 98.9% and extended from 27 months to 8 years (348.7 patient years in group I and 23.08 patient years in group II). The overall 5 and 8 years actuarial survival, freedom of thromboembolism and freedom from endocarditis rates in group I were: 80.8 +/- 4.4% and 72.7 +/- 5.2%; 89.8 +/- 4% and 85.8 +/- 4.7%; 94.8 +/- 1.2 and 93.1 +/- 1.7%. In group II, actuarial studies were not carried out because of the scanty number of cases. There were another complications in group I: haemorrhage due to anticoagulation in 6 cases, hemolysis in 8 instances and periprosthetic leaks in 2 cases. There were no cases of structural failure. We conclude that after 8 years of follow-up the M-H valve prosthesis shows an excellent clinical performance and mechanical reliability, and the incidence of valve-related complications was in the low range of that reported with other mechanical prostheses.