[Double mitral and aortic valve replacement: 322 cases operated on between 1970 and 1985].

Over this 15-year period, 322 combined aortic and mitral valve replacements were performed by the same surgeon. Bioprostheses were used in only 4 patients, 318 received a double mechanical prosthesis. The Bjork-Shiley valve was always used for the aortic orifice. For the mitral orifice, three types of valve were implanted: 160 Starr-Edwards 6120 valves, 59 Bjork-Shiley valves and 99 St-Jude Medical valves. The early post-operative mortality was 5.9 p. 100. It was due to cardiac causes in 73.7 p. 100 of the cases and was significantly influenced by the myocardial protection technique (p less than 0.05). A long-term review of the survivors was carried out in november-december, 1986: 15 patients were lost sight of; there were 63 late deaths 77.8 p. 100 of which were either of cardiac origin or due to the prosthesis. 225 patients have survived with a mean follow-up of 79.1 months. The actuarial survival rate (early post-operative mortality included) was 78.2 p. 100 at 5 years and 70.2 p. 100 at 10 years. The incidence of peripheral arterial embolism was 1.9 p. 100 per patient-year, while that of all thromboembolic complications (sudden deaths included) was 3.4 p. 100 per patient-year. The percentages per patient-year of the other complications observed were: haemorrhages 2.2 p. 100, infective endocarditis 0.40 p. 100, reoperation 0.47 p. 100. The proportions of patients free of any complication were 84.8 p. 100 at 5 years and 79.7 p. 100 after 10 years.(ABSTRACT TRUNCATED AT 250 WORDS)