Results of prosthetic valve replacement for aortic stenosis

Background: Aortic valve replacement with mechanical valves is associated with a small but constant risk of valve thrombosis and thromboembolic and hemorrhagic complications. The surgical outcome of patients with Aortic Stenosis who had aortic valve replacement with mechanical valves is reported here. Methods: Between January 1990 and October 1999, 275 patients underwent prosthetic valve replacement for isolated aortic stenosis. The age ranged between 13 years and 75 years and 230 were males. The cause of aortic stenosis was rheumatic in 185 patients (67. 3%), followed by bicuspid aortic valve in 75 patients (27. 3%) and degenerative in 15 patients (5. 4%). Results: The early mortality was 1. 5%. The follow up was 96% complete and ranged from 1 to 104 months (mean 54±24. 5months). Six patients (2. 2%) developed prosthetic valve endocarditis. Paravalvular leak occurred in 3 (0. 9%) patients. Valve thrombosis occurred in 10 patients (1. 0% per patient year). The actuarial survival was 81±7% at 5 years and 64±13% at 8 years. Event free survival was 40±14% at 8 years. Conclusion: With current operative techniques and myocardial preservation aortic stenosis patients are at low risk for surgery. However, long term survival is limited due to prosthesis related complications. © 2002 IJTCVS.