Twenty-year Experience of Mitral Valve Replacement with the St. Jude Medical Mechanical Valve Prosthesis

Seo, Yeon Ho; Kim, Kong Soo; Jo, Jung Ku

Abstract

BACKGROUND: A retrospective study was conducted to analyze the results of St. Jude Medical mitral valve replacement at the Chonbuk National University Hospital since the initial implant in May 1984. MATERIAL AND METHOD: Between May of 1984 and December of 1996, 95 patients underwent MVR with the St. Jude Medical mechanical valve prosthesis at Department of Medical Science of Chonbuk National University Hospital and follow-up ended in May of 2004. RESULT: Age ranged from 19 to 69 years. Follow-up (mean+/-standard deviation) averaged 10.6+/-4.2 year. Thirty-day operative mortality was 4.2% (4/95). Nine late deaths have occurred and actuarial survival was 90.5+/-3.0%, 87.9+/-3.4% and 83.2+/-4.6% at 5, 10 and 20 years, respectively. Probability of freedom from valve-related death was 95.5+/-2.1%, 94.3+/-2.4% and 91.0+/-3.9% at 5, 10 and 20 years, respectively. Seven patients have sustained thromboembolic events (1.05%/patient-year). Fifteen patients had anticoagulation related hemorrhage (3.56%/patient-year). There was no structural valve deterioration. Probability of freedom from all complications was 82.0+/-3.9%, 71.3+/-4.8% and 42.4+/-10.5% at 5, 10 and 20 years, respectively.
CONCLUSION
We confirm the effective and excellent durability of the St. Jude Medical prosthesis in the mitral position with a low event rate at long-term follow-up. It also demonstrates the commonly encountered practical difficulty of adjusting the anticoagulation protocol in patients with prosthetic mitral valves.