[Retrospective study of 412 aortic valve replacements by Bjork-Shiley prosthesis implanted between January 1972 and October 1984. Actuarial survival, mortality, complications].

Between January 1972 and October 1984, 412 aortic valve replacements by Bjork-Shiley disk prosthesis were performed. 183 patients suffered from aortic incompetence, 132 from an aortic disease and 97 from aortic stenosis. 116 associated procedures (28%) were performed = 36 myocardial revascularizations, 61 Bentall operations, 12 patch grafts to the ascending aorta and 7 Wheat operations. The mean age was 53.6 years and 25% of the patients were over the age of 65 years. Fifty percent of the patients had stage III or IV disease according to the NYHA classification. The cardiac index was less than 2.3 l/min/m2 in 44.26% of cases. The early postoperative mortality was 4.85% and 20% of these deaths were related to the prosthesis. The late mortality was 17.25%, with 20% of deaths related to the valve. The mean follow-up 59.75 +/- 2 months (range: 1 to 166 months) with a cumulative survival of 2.092 patients-years. It was significantly influence by the existence of preoperative angina, another operation associated with AVR and a cardiac index less than 2.3 l/min/m2. Seventy-one complications were related to the prosthesis including dysfunction (0.05% patient-year), 3 valve thromboses (0.15% patient-year), 6 infected valves (0.31% patient-year), 12 cases of peri-prosthetic dehiscence (0.61% patient-year), 10 embolic complications (0.61% patient-year) and 37 complications related to anticoagulants, including 26 major complications (1.48% patient-year). The valve failure rate was 1.19% patient-year. The results of our series are comparable to those reported in the literature, which confirm the reliability of the Bjork-Shiley Valve.