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The Journal of Thoracic and Cardiovascular Surgery, Vol 91, 807-817, Copyright © 1986 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
RS Mitchell, DC Miller, EB Stinson, PE Oyer, SW Jamieson, JC Baldwin and NE Shumway
With rare exception, the bulk of out knowledge concerning the performance
of any particular valve substitute originates from one institution; thus,
if valve-related complications are more a function of the patient substrate
undergoing operation than the prosthesis per se, the usefulness of
inter-institutional comparisons would be severely limited. To address this
question, the outcome of 2,719 patients after mitral or aortic valve
replacement over 12,955 patient-years of follow- up was analyzed by
time-dependent multivariate statistical methods with respect to
thromboembolic events, anticoagulant-related hemorrhage, valve failure,
fatal valve failure, all valve-related morbidity and mortality, necessity
for reoperation, and late survival. Many patient- related factors were
significant predictors of the probability of certain patient groups for
sustaining these valve-related complications. Hence, comparisons of results
of valve performance from different institutions may be misleading unless
patient populations are comparable.
ARTICLES
Significant patient-related determinants of prosthetic valve performance
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