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The Journal of Thoracic and Cardiovascular Surgery, Vol 91, 807-817, Copyright © 1986 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Significant patient-related determinants of prosthetic valve performance

RS Mitchell, DC Miller, EB Stinson, PE Oyer, SW Jamieson, JC Baldwin and NE Shumway

With rare exception, the bulk of out knowledge concerning the performance of any particular valve substitute originates from one institution; thus, if valve-related complications are more a function of the patient substrate undergoing operation than the prosthesis per se, the usefulness of inter-institutional comparisons would be severely limited. To address this question, the outcome of 2,719 patients after mitral or aortic valve replacement over 12,955 patient-years of follow- up was analyzed by time-dependent multivariate statistical methods with respect to thromboembolic events, anticoagulant-related hemorrhage, valve failure, fatal valve failure, all valve-related morbidity and mortality, necessity for reoperation, and late survival. Many patient- related factors were significant predictors of the probability of certain patient groups for sustaining these valve-related complications. Hence, comparisons of results of valve performance from different institutions may be misleading unless patient populations are comparable.

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