The Long-term Clinical Result of St. Jude Mechanical Valve Replacement

Bae, Yun Suk; Jung, Sung Chol; Kim, Woo Sik; Chung, Sung Hyock; Yoo, Hwan Kook; Lee, Jung Ho; Kim, Byung Yul

Abstract

BACKGROUND: The St. Jude Medical prosthesis is one of the popularly used artificial prosthesis, therefore the National Medical Center reports the long-term clinical results of patients who underwent prosthetic valve replacement with St. Jude medical valve for 18 years. MATERIAL AND METHOD: Between January, 1984 and June, 2002, a series of 163 consecutive patients who had implanted St. Jude prosthesis at the National Medical Center were reviewed. Mean age was 42.9+/-15.1 years and male to female ratio was 69:94. The operative procedure comprised of 87 MVR, 30 AVR, 45 DVR, and 1 TVR. The reoperative procedure comprised of 21 MVR, 2 AVR, and 14 DVR. Follow-up rate was 96.9%, and cumulative follow-up was 823.8 patient-years. RESULT: Early mortality rate was 7.9% (13 patients), late mortality rate was 8.7% (13 patients) and late mortality due to valve related complication was 4.7% (7 patients). Actual survival rate at 10 and 18 years were 91.7+/-2.1% and 91.0+/-1.9%. Linearized incidence was as follows: thromboembolism, 1.09%/ patient-year; anticoagulant related hemorrhage, 0.36%/patient-year; valve thrombosis, 0.24%/patient-year; paravalvular leakage, 0.12%/patient-year; and prosthetic bacterial endocarditis, 0.12%/patient-year. Linearized incidence of over all valve related complication was 1.94%/patient-year. Freedom from valve related complication at 10 and 18 years were 89.1+/-3.3% and 88.4+/-3.9%. Freedom from valve related death at 10 and 18 years were 95.1+/-1.2% and 95.1+/-1.0%. Valve related complication was related the age of patient, especially anticoagulant related hemorrhage was more common in patients over 60 years of age. Valve related complication, death were higher in DVR than AVR or MVR, and valve related death was higher in reoperation. There was no relationship between valve related complication or death and implant valve or size.
CONCLUSION
The long-term clinical results of patients implanted with St. Jude Mechanical prosthesis was quite satisfactory with a low incidence of valve related complication and mortality.