A thirteen-year review of the Magovern-Cromie aortic valve.

A review of 375 cases of aortic valve replacement with the Magovern-Cromie sutureless prosthesis demonstrated a 43 per cent survival rate 10 to 13 years following the operation. Of the 308 patients surviving zero to 30 days, 238 patients are alive after one to 14 years. A total of 70 patients (22 per cent died during the 14 year follow-up period. The actuarial survival rate of all patients at risk was 64 per cent at the fifth year and 51 per cent at the tenth year. For those patients who lived at least one year after surgery, the probability of survival was 84 per cent and 70 per cent at 5 and 10 years, respectively. These results compare favorably with reports of up to only 8 years with the Smeloff-Cutter and Starr-Edwards prostheses. There was only a 1.5 per cent incidence of perivalvular leak with this method of fixation, and no valve has migrated. Ball variance has not occurred with any valve inserted since 1964, and the incidence of thromboembolism with the Model A4 prosthesis is 2.4 per cent. Improvement in results depend on reduction of thromboembolism, lessening of late and operative morality rates, and by earlier operative intervention to reduce the late deaths from cardiogenic factors.