DeBAKEy CARDIOvASCuLAR JOuRNAL - Methodist Hospital

Image provided courtesy of W.L. Gore & Associates, Inc.
Figure 18. Left: Mitral valve repair involving quadrangular resection
of posterior leaflet. Right: Mitral valve repair involving chordal
replacement with Gortex.
150
120
90
60
30
0
123
6
4.6%
1965-1975
Cases 129
111
4
3.4%
1976-1985
Cases 115
Aortic, mitral and tricuspid
Valve repair = 456
OP survival = 435
OP death = 21 4.6%
Figure 19. Aortic, mitral and tricuspid valve repair; STS benchmark
for mitral valve repair 1991 = 4.2%
involved valve repair or reconstruction of the aortic,
mitral (Figure 18), or tricuspid valve. In this group, the
30-day mortality averaged 4.6%, favorably compared
to the STS benchmark for mitral valve repair in 1991 of
4.2% (Figure 19).
Aortic Valve With Associated Procedures
Aortic valve replacements with one or more associated
procedures numbered 806 accounting for more
than 50% of the total Av valve procedures performed.
The most common associated procedures included
CAB, reconstruction of an ascending aortic aneurysm,
or some other valve procedures. There were 741 survivors
and 65 operative deaths for a 30-day operative
mortality of 8.0%, more than doubling the operative
mortality for isolated aortic valve replacement (Figure
20). Similarly with mitral valve replacement, there was
an increase in complexity and comorbidity. There were
334 mitral valve replacements with associated procedures
and 47 deaths for 30-day operative mortality of
14% (Figure 21).
In this series, there were 23 tricuspid valve replacements,
always associated with concomitant aortic or
115
4
3.1%
1986-1995
Cases 119
86
7
7.5%
1996-2005
Cases 93
Figure 20. AVR with associated procedures
Figure 21. MVR with associated procedures
LVA = 376
OP survival = 348
OP death = 28 7.4%
Figure 22. LVA
8 vII (1) 2011 | MDCvJ
250
200
150
100
50
0
150
120
90
60
30
0
200
150
100
50
0
91
15
14.0%
1965-1975
Cases 106
41
239
22
8.4%
1976-1985
Cases 261
232
10
4.1%
1986-1995
Cases 242
AVR with associated procedures = 806
OP survival = 741
OP death = 65 8.0%
13
24%
1965-1975
Cases 54
80
124
20
13.8%
1976-1985
Cases 144
89
9
9.2%
1986-1995
Cases 98
MVR with associated procedures = 334
OP survival = 287
OP death = 47 14%
7
8%
1965-1975
Cases 87
159
12
7%
1976-1985
Cases 171
83
5
5.6%
1986-1995
Cases 88
179
18
9.1%
1996-2005
Cases 197
33
5
13%
1996-2005
Cases 38
26
4
13%
1996-2005
Cases 30