Summary
Homologous dura mater bioprostheses have been used for over 6 years in 217 patients
who have undergone cardiac valve replacement at Chulalongkorn Hospital and Medical
School, Bangkok. The mitral valves were replaced in 151 patients (69.6%), aortic valve
replacements were performed in 29 patients (13.7%), and multiple valve replacement
were performed in 37 patients (16.7%). This study will be confined mainly to the isolated
mitral and aortic valve replacements. The early deaths in the mitral replacement series
was 10.5%, and 13.8% in the aortic valve replacement. Myocardial (pump) failure was
the cause of early death in the majority of cases. The late mortality was 7.3% in
the mitral position and 12.0% in the aortic position. The mean improvement of NYHA
class was from 3.76 to 1.13 in the mitral series, and from 3.64 to 1.32 in the aortic
group. The actuarial survival rates at 6 years after operation were 87 % and 84 %
respectively and compare favorably with several prostheses currently in use.
There was no case of thromboembolism even though no anticoagulants were used.
Key words
Heart valve replacement - Biological valve prosthesis - Dura mater heart valve - Prosthetic
degeneration - Long-term results
