Experience with surgery of the heart valves.

A review is given of a 15 year experience of valve replacement with Teflon cusps, pericardial cusps, Starr-Edwards, Key-Shiley, Wada-Cutter and Björk-Shiley artificial valve prosthesis. The Björk-Shiley tilting disc valves have shown the lowest gradient and blood trauma and excellent durability in more than 1 000 implantations during a 7 year period. Anticoagulation therapy is considered necessary with all types of artificial heart valves. Thrombo-embolism is negligible after aortic valve replacement (1 episode in 4 000 patient months) but still a problem in the mitral position (4 episodes in 1 000 patient months).