Cardiac valve prostheses at autopsy: an analysis of 337 cases with clinicopathologic correlation.

We evaluated the pathologic findings at autopsy in 337 patients who had undergone cardiac valve replacement over 10 years (1982 to 1991). Rheumatic heart disease was the most common indication for valve replacement (84% of cases). Among the 255 patients with short-term survival (<1 month), in 162 cases (63.5%), the cause of death was related to surgery and/or underlying cardiovascular conditions. Host-prosthetic valve interactions contributed to mortality in 14.9% cases. However, in longtime survivors (82 patients), a significant number (86.5%) showed evidence of prosthesis-related complications, such as infective endocarditis, thrombosis, anticoagulant-related hemorrhage, and bioprosthetic valve degeneration.