[Mortality and other time-related successes after valve replacement with the Björk-Shiley Monostrut prosthesis. A 5-year experience. The Spanish Monostrut Study Group].

With rare exceptions, hospital mortality, late survival, and valve-related complications are correlated with the characteristic of the population being studied. To identify the factors that can affect the clinical course of these patients, we reviewed the clinical data of 2,726 patients from 14 hospitals in Spain operated on between January 1983 and December 1987. During this period, there were 1,128 aortic valves replacements, 1,165 mitral valve replacements, and a total of 433 double valve replacements. Afterwards, it was necessary to perform 40 new valvular implantations, either to change a prosthetic valve or to replace the native valve. In total, 3,199 Björk-Shiley Monostrut valves were replaced. Forty-seven preoperative, intraoperative, postoperative, and late follow-up variables were analyzed using multiple logistic regression methods to establish the risk factors correlated with hospital mortality. Time-related multifactorial analysis was employed to identify the risk factors correlated with late mortality, thromboembolism, anticoagulant related hemorrhage, prosthetic valve endocarditis, and non-structural dysfunction. Risk factors were those considered to have reached statistical significance in each analysis. Considering the number of patients, the homogeneous characteristics of the surgical procedures and the follow-up time obtained (5,457 patients/year), we have identified the risk factors that can be useful in the proper selection of patients who are candidates for valve replacement with the Björk-Shiley Monostrut prosthesis.