Thirty-year experience with a bileaflet mechanical valve prosthesis

The Journal of Thoracic and Cardiovascular Surgery

Scott Johnson¹  Martha R. Stroud² 

[1] Division of Cardiothoracic Surgery, Medical University of South Carolina, Charleston, SC;Division of Cardiothoracic Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC

关键词: aortic valve;    mechanical valve prosthesis;    mitral valve;    St Jude Medical;    valve replacement;   

DOI  :  10.1016/j.jtcvs.2018.09.002

学科分类：心脏病和心血管学

来源: Mosby, Inc.

【 摘 要 】

BackgroundThe objective was to evaluate the long-term outcomes of the St Jude Medical (Saint Paul, Minn) mechanical valve prosthesis implantation.MethodsSince 1979, every patient receiving this prosthesis has been followed annually.ResultsFrom January 1979 to December 2014, 1023 patients were accrued. Patients' ages ranged from 18 to 85 years. Aortic valve replacement was performed in 584 patients, and mitral valve replacement was performed in 439 patients. Follow-up was 95% complete. Operative mortality was 3% (17/584, aortic valve replacement) and 4% (18/439, mitral valve replacement). In patients undergoing aortic valve replacement, late actuarial survival was 62% ± 2%, 32% ± 2%, and 14% ± 3% at 10, 20, and 30 years, respectively. Thirty-year freedom from reoperation, thromboembolism, valve thrombosis, bleeding, and endocarditis was 92% ± 2%, 79% ± 3%, 96% ± 1%, 56% ± 5%, and 92% ± 2%, respectively. In patients undergoing mitral valve replacement, late actuarial survival was 64% ± 3%, 28% ± 3%, and 14% ± 3% at 10, 20, and 30 years, respectively. Thirty-year freedom from reoperation, thromboembolism, valve thrombosis, bleeding, and endocarditis was 85% ± 5%, 55% ± 6%, 99% ± 1%, 57% ± 6%, and 95% ± 2%, respectively. The incidence of bleeding was 2.5% and 2.0% per patient-year for aortic valve replacement and mitral valve replacement, respectively. The incidence of thromboembolism was 1.6% and 2.9% per patient-year for aortic valve replacement and mitral valve replacement, respectively.ConclusionsAnnual follow-up of all of our patients receiving a St Jude Medical mechanical valves prosthesis has allowed better identification valve-related issues and events. After 3 decades of observation with close follow-up, the St Jude Medical mechanical valve continues to be a reliable prosthesis.

【 授权许可】

Unknown