Bivalvular mechanical Mitral-Aortic valve replacement in 254 patients: Long-Term results—a 22-year follow-up Jean-Paul Remadi, MD, Olivier Baron, MD,

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Bivalvular mechanical Mitral-Aortic valve replacement in 254 patients: Long-Term results—a 22-year follow-up Jean-Paul Remadi, MD, Olivier Baron, MD, C Tribouilloy, PhD, Jean C Roussel, MD, O Al Habasch, MD, Philippe Despins, MD, Jean- Luc Michaud, MD, Daniel Duveau, MD The Annals of Thoracic Surgery Volume 76, Issue 2, Pages 487-492 (August 2003) DOI: 10.1016/S0003-4975(03)00674-X

Fig 1 Causes of mitral and aortic valve disease. Numbers appearing next to each bar indicate number of patients. (CMO = obstructive cardiomyopathy.) The Annals of Thoracic Surgery 2003 76, 487-492DOI: (10.1016/S0003-4975(03)00674-X)

Fig 2 New York Heart Association class for patients undergoing double-valve replacement. Preoperative class (top) and class after 22 years of follow-up (bottom) is shown. The Annals of Thoracic Surgery 2003 76, 487-492DOI: (10.1016/S0003-4975(03)00674-X)

Fig 3 Numbers of patients receiving various diameters of aortic (top) and mitral (bottom) prostheses. Numbers in labels for different prostheses indicate size in millimeters. (bs = Björk-Shiley; smj = St. Jude Medical.) The Annals of Thoracic Surgery 2003 76, 487-492DOI: (10.1016/S0003-4975(03)00674-X)

Fig 4 Comparison of cardiac rhythm changes for all patients preoperatively and postoperatively, and as reported in initial follow-up (1994) and current follow-up (2001). (AF = atrial fibrillation; PM = pacemaker; SIN = sinus rhythm.) The Annals of Thoracic Surgery 2003 76, 487-492DOI: (10.1016/S0003-4975(03)00674-X)

Fig 5 Actuarial survival curves for overall mortality (black symbols) and valve-related mortality (gray symbols). Patients at risk are shown below. The Annals of Thoracic Surgery 2003 76, 487-492DOI: (10.1016/S0003-4975(03)00674-X)

Fig 6 Valve-related morbidity as a function of reoperation (diamonds), thrombosis (gray squares), endocarditis (triangles), hemorrhage (black squares), paravalvular leak (small black rectangles), and thromboembolism (dashed line). The Annals of Thoracic Surgery 2003 76, 487-492DOI: (10.1016/S0003-4975(03)00674-X)

Fig 7 Actuarial survival curves comparing patients with bivalvular replacement (diamonds) and those with isolated mitral valve replacement (squares). The Annals of Thoracic Surgery 2003 76, 487-492DOI: (10.1016/S0003-4975(03)00674-X)