Comparison of Reoperation and Complications in Double Valve (Mitral and Aortic) Implants with Mechanical or Biological Prostheses
A total of 1160 patients received a double valve implant, in the mitral and aortic positions, between January 1970 and December 1986. Either mechanical (984 patients) or biological (176 patients) valves were implanted. Operative mortality was 8%. Patients were followed-up for a total of 4641 patient-years (mean 5.12) in the mechanical valve group and a total of 1106 patient-years (mean 6.86) in the biological valve group. There was a significantly higher incidence of reoperation (p < 0.001) in the biological valve compared to the mechanical group because of a high number of primary tissue failures. An analysis of the actuarial data shows no significant difference in long-term survival. In conclusion, we think that the indications for double (mitral and aortic) biological valve implantation should be analyzed carefully. Given the freedom from reoperation after 12 years of only 28%, only very specific cases should be considered for biological valve implantation.