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The long-term results of open-heart valve surgery in Uppsala in the period 1959-1974 were reviewed. The total number of patients operated on was 677 and the mean follow-up time was 10 years (range 5-22 years). The operative mortality was high in the early years, but fell to 11-12% towards the end of the period. The main long-term complication was embolism. The frequency of late reoperation was 10-20%, reflecting the limited durability of the early mechanical valves and of subsequently used biologic valves. The actuarial 10-year survival, calculated as 50%, was approximately equal among the patients with aortic and those with mitral valve disease. The predominant late causes of death (60-75%) were 'cardiac', including myocardial as well as valve-related causes. Follow-up investigation comprised 244 survivors. In general there was considerable functional improvement both in the aortic and in the mitral group. Valvular insufficiency leading to reoperation was detected at follow-up examination in 6-8% of the patients.

A case of malignant leiomyosarcoma presenting as a left atrial cardiac tumor is described and its echocardiographic features are discussed. Tumor masses invading the atrial walls were extensively resected and the atrial wall was reconstructed with two patches of bovine pericardium.