[Late complications following Björk-Shiley and Carpentier-Edwards heart valve replacements].

Valve related and valve induced, fatal or non fatal complications after Björk-Shiley valve replacement (n = 50) are compared with complications following Carpentier-Edwards valve replacement (n = 113). These patients had been operated upon between 1976 and 1982 and were followed up until 1985. Estimated actuarial cumulative survival following Carpentier-Edwards valve replacement (53 +/- 12% after a 100-month period) did not differ significantly from the estimate following Björk-Shiley valve replacement (80 +/- 6% after a 100-month-period), and subgroups of the cohort did not differ in survival after Carpentier-Edwards or Björk-Shiley valve replacement either. However, the estimate of actuarial cumulative event-free survival following Carpentier-Edwards valve replacement in patients under 40 years of age (46 +/- 14% after a 92-month period) was significantly worse (p less than 0.05) than with Björk-Shiley valves (100 +/- 0% after a 92-month period), (n = 30). The leading cause of clinical complications following Carpentier-Edwards valve replacement was a demonstrable degeneration of the bioprosthesis in 12 cases. The diagnosis of degeneration was established a mean of 73 months postoperatively (range 42-101 months).