Outcome of double vs. single valve replacement for XXXX .

@entity6331 @entity1 @entity64 @entity548 @entity886 @entity715
OBJECTIVE: To compare the follow-up results of double valve replacement (DVR) i.e. mitral valve replacement (MVR) and aortic valve replacement (AVR) vs. isolated MVR or AVR for @entity6331 . STUDY DESIGN: An interventional qausi-experimental study. PLACE AND DURATION OF STUDY: Department of Cardiac Surgery, Punjab Institute of Cardiology, Lahore, from September 1994 till December 2007. METHODOLOGY: Prospective follow-up of 493 @entity1 with mechanical heart valves was carried out using clinical assessment, international normalized ratio and echocardiography. @entity1 were divided into three groups: group I having MVR, group II having AVR and group III having DVR. Survival, time and causes of mortality, and frequency of valve @entity715 , @entity548 and @entity548 was noted in the three groups and described as proportions. Actuarial survival was analyzed by Kaplan-Meier method. RESULTS: There were 493 with 287 (58.3%) in group I, 87 (17.6%) in group II and 119 (24.1%) in group III. Total follow-up was 2429.2 @entity1 (pt)-years. Of 77 (15.6%) deaths, 19 (3.8%) were in-hospital and 58 (11.8%) were late. In-hospital mortality was highest 4 (4.6%) in group II followed by 5 (4.2%) group III and 10 (3.5%) group I. Late deaths were 39 (13.4%) in group I, 9 (10.2%) in group II and 10 (8.3%) in group III. The total actuarial survival was 84.4% with survival of 83%, 85.1%, 87.4% in groups I, II and III respectively. On follow-up valve @entity715 occurred in 12 (0.49%/pt-years) @entity1 ; 9 (0.67%/pt-years) group I, 1 (0.22%/pt-years) in group II and 2 (0.31%/pt-years) in group III. Severe @entity548 occurred in 19 (0.78%/pt-years); 14 in (1.04%/pt-years) in group I, 3 (0.66%/pt-years) group II and 2 (0.31%/pt-years) in group III. @entity64 occurred in 34 (1.3%/pt-years); 26 (1.95%/pt-years) in group I and 4 in groups II (0.89%/pt-years) and III (0.62%/pt-years) each. CONCLUSION: In @entity1 with @entity6331 having combined mitral and @entity886 DVR should be performed whenever indicated as it has similar in-hospital mortality and better late survival as compared to isolated aortic or mitral valve replacement.
