[Medico-surgical experience in dysfunction of heart valve prostheses. Report of 55 cases].

The medical and surgical outcome of 55 patients with prosthetic valve disfunction are reported (39 bioprosthesis and 16 mechanical). Fifty patients were operated and five had medical treatment. The group of patients with mechanical prosthesis had a functional class of 2.4 +/- .74 vs patients with bioprosthesis who had a functional class of 2.8 +/- .71. Forty eight patients (87%) had congestive heart failure, four systemic emboli and three infective endocarditis. Three cases with mechanical prosthesis in tricuspid position were subjected to thrombolysis with streptokinase and experienced clinical and echocardiographical improvement. Time elapsed from original implantation and valve disfunction was 66 +/- 56 months for mechanical prosthesis vs 108 +/- 37 months in bioprosthesis (p less than 0.01), three patients died at surgery and two during the waiting period. All deaths resulted from cardiogenic shock. All of them were previously on functional class IV.