PMID- 10543481
OWN - NLM
STAT- MEDLINE
DCOM- 19991109
LR  - 20190628
IS  - 0003-4975 (Print)
IS  - 0003-4975 (Linking)
VI  - 68
IP  - 4
DP  - 1999 Oct
TI  - Long-term experience with the St. Jude Medical valve prosthesis.
PG  - 1210-8
AB  - BACKGROUND: All patients undergoing St. Jude Medical valve replacement at the 
      Medical University of South Carolina since January 1979 have been followed 
      prospectively at 12-month intervals. METHODS: This report describes long-term 
      experience in 710 adult patients undergoing isolated aortic (AVR) (418) or mitral 
      valve replacements (MVR) (292) with this prosthesis from January 1979 to December 
      1996. RESULTS: Ages ranged from 19 to 84 years (54.8 +/- 15.1 AVR, 51.8 +/- 12.9 
      MVR; mean +/- SD). Male gender predominated in the AVR group (70%) and female 
      gender in the MVR group (62%). One hundred and fifty-seven patients (22%) had 
      associated coronary artery bypass grafting (AVR 27%, MVR 15%). Thirty-day 
      operative mortality was 5.3% (22/418) in the AVR group and 5.1% (15/292) in the 
      MVR group. Follow-up is 96.9% complete and ranges from 1 month to 16.9 years 
      (AVR, 2,376 patient-years, mean 5.7 +/- 4.5 years; MVR, 1,868 patient-years, mean 
      6.4 +/- 4.8 years). In the AVR group, 120 late deaths have occurred and actuarial 
      survival was 78.0 +/- 2.3%, 58.0 +/- 3.2%, and 36.8 +/- 4.8%; at 5, 10, and 15 
      years, respectively. Forty-six patients have sustained 55 thromboembolic (TE) 
      events (2.3%/patient-year). Fifty-one patients had anticoagulant-related bleeding 
      complications (2.7%/patient-year). The mean improvement in New York Heart 
      Association (NYHA) functional class from preoperative to postoperative was 3.0 
      +/- 0.8 to 1.7 +/- 0.1 (p < 0.05). In the MVR group, there have been 84 late 
      deaths, and the actuarial survival was 79.3 +/- 2.5%, 60.1 +/- 3.5%, and 49.3 +/- 
      4.1% at 5, 10, and 15 years, respectively. Fifty-two patients have had 64 TE 
      events (3.5%/patient-year). Twenty-three patients had anticoagulant-related 
      bleeding complications (1.6%/patient-year). The mean improvement in NYHA 
      functional class was from 3.3 +/- 0.6 to 1.8 +/- 0.1. There were no mechanical 
      failures in either group. CONCLUSIONS: With a follow-up now extending to 17 
      years, the St. Jude Medical valve continues to be a reliable mechanical 
      prosthesis with low and stable rates of valve-related complications.
FAU - Zellner, J L
AU  - Zellner JL
AD  - Division of Cardiothoracic Surgery, Medical University of South Carolina, 
      Charleston 29425, USA. zellnejl@musc.edu
FAU - Kratz, J M
AU  - Kratz JM
FAU - Crumbley, A J 3rd
AU  - Crumbley AJ 3rd
FAU - Stroud, M R
AU  - Stroud MR
FAU - Bradley, S M
AU  - Bradley SM
FAU - Sade, R M
AU  - Sade RM
FAU - Crawford, F A Jr
AU  - Crawford FA Jr
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
SB  - IM
MH  - Actuarial Analysis
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Valve/*surgery
MH  - Cause of Death
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Valve Diseases/mortality/*surgery
MH  - *Heart Valve Prosthesis
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve/*surgery
MH  - Postoperative Complications/mortality
MH  - Prosthesis Design
MH  - Prosthesis Failure
EDAT- 1999/10/30 09:00
MHDA- 2001/03/28 10:01
CRDT- 1999/10/30 09:00
PHST- 1999/10/30 09:00 [pubmed]
PHST- 2001/03/28 10:01 [medline]
PHST- 1999/10/30 09:00 [entrez]
AID - S0003-4975(99)00985-6 [pii]
AID - 10.1016/s0003-4975(99)00985-6 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 1999 Oct;68(4):1210-8. doi: 10.1016/s0003-4975(99)00985-6.