Document Detail

Comparison of the causes of late death following aortic and mitral valve replacement. VA Co-operative Study on Valvular Heart Disease.
MedLine Citation:
PMID:  8162209     Owner:  NLM     Status:  MEDLINE    
This report examines and compares the causes of late non-surgical death in 146 of 690 (21%) patients undergoing isolated aortic valve replacement (AVR) and in 79 of 273 (29%) patients undergoing mitral valve replacement (MVR) over a five year follow up period. The distribution of valve related, cardiac but not valve-related and non-cardiac deaths was 43%, 23% and 34% respectively for AVR and 65%, 29% and 6% respectively for MVR; the difference between these distributions was statistically significant. The specific causes of valve related deaths included bleeding (11% vs. 5% for MVR vs. AVR), systemic embolization (6% vs. 4% for MVR vs. AVR), endocarditis (14% vs. 8% for MVR vs. AVR), valve regurgitation (8% vs. 5% for MVR vs. AVR) and valve obstruction (3% vs. 5% for MVR vs. AVR). Sudden death (less than one hour from the onset of acute symptoms) accounted for 23% of deaths for MVR and 16% for AVR. The deaths due to congestive heart failure with normal prosthetic valve function were 13% and 8% for MVR and AVR respectively. Non-cardiac causes accounted for only 6% of MVR deaths but 34% of AVR deaths (p < 0.001). There was no significant difference in the late mortality between mechanical and bioprosthetic valves in the aortic position (24% vs. 22%), but the cumulative rate of late deaths was higher in patients with the Björk-Shiley than with the Hancock valve in the mitral position (41% vs. 25%, p < 0.02). In conclusion, about one quarter of patients surviving either aortic or mitral valve replacement died within five years.(ABSTRACT TRUNCATED AT 250 WORDS)
M H Hwang; C M Burchfiel; G K Sethi; C Oprian; F L Grover; W G Henderson; K Hammermeister
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  The Journal of heart valve disease     Volume:  3     ISSN:  0966-8519     ISO Abbreviation:  J. Heart Valve Dis.     Publication Date:  1994 Jan 
Date Detail:
Created Date:  1994-05-20     Completed Date:  1994-05-20     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9312096     Medline TA:  J Heart Valve Dis     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  17-24     Citation Subset:  IM    
VA Hospital, Hines, IL.
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MeSH Terms
Aortic Valve / surgery
Cause of Death*
Death, Sudden / epidemiology
Heart Valve Diseases / mortality,  surgery
Heart Valve Prosthesis / mortality*
Middle Aged
Mitral Valve / surgery
Prospective Studies
Survival Rate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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