Clinical experience with the Smeloff-Cutter aortic valve prosthesis: an 8-year follow-up study.

A total of 46 patients who survived aortic valve replacement with the present model Smeloff-Cutter prosthesis between 1968 and 1973 were followed up postoperatively. All patients received oral anticoagulant therapy. The average age at implantation was 44 +/- 13 (mean +/- standard deviation) years; 36 patients were male and 10 were female. The valve damage was caused by rheumatic disease in 19 (41 percent), infective endocarditis in 14 (30 percent), congenital heart disease in 7 (15 percent) and other factors in 6 (13 percent). Late death occurred in eight patients (17 percent). All available patients were followed up until December 1976. During the 8 years of follow-up study, seven patients, including four heroin addicts, had postoperative endocarditis (15 percent); five of the seven had cerebral involvement, possibly from septic emboli. Four patients were reoperated on; three had active endocarditis and one had a high transvalve pressure gradient. The mean follow-up time was 4.9 years per patient. Of the 38 living patients, 33 have functional improvement and are still being followed up. Only one patient had a bland embolism to a systemic artery. No ball variance or other types of material failure have been detected. Although the chronic aspects of valve disease remain after prosthetic valve replacement, the Smeloff-Cutter aortic prosthesis deserves strong consideration when selecting a rigid prosthesis for aortic valve replacement.