Long Term Results of Valve Replacement with the St. Jude Medical Heart Valves: Thirteen Year Experience

Kim, Chang Gon; Kuh, Ja Hong; Jo, Jung Ku; Kim, Kong Soo

Abstract

Between May 1984 and January 1996, 130 patients were replaced cardiac valve using 150 St. Jude Medical prosthetic valves(42 aortic, 68 mitral, 20 aortic and mitral valve replacements). Follow-up was 97.6% complete. The early mortality rate was 5.4%, and late mortality rate was 4.9%. The valve-related late mortality rate was 3.3%. Of late complications, there were 6 anticoagulant related hemorrhages, 4 thromboembolisms and 1 paravalvular leakage. Linearized rates of late complication and valve-related late mortality were as follows: total late complications, 1.68% per patient-year: anticoagulant related hemorrhages, 0.92% per patient-year: thromboembolism, 0.61% per patient-year: paravalvular leakage, 0.15% per patient-year: reoperation, 0.15% per patient-year: and valve-related late mortalities, 0.61% per patient-year. Actuarial event free rate at 10 years was 87.4+/-3.2%. The overall actuarial survival rate was 90.4+/-2.7% at 5 years, 87.5+/-3.3% at 10 years. Ninety eight percent of the survivors were in the New York Heart Association functional class I or II at the end of follow-up. There was significant improvement of cardiothoracic ratio. In conclusion, this study suggests the excellent durability of the St. Jude Medical Heart valve and remarkable functional benefit for the majority of the patients. However, prosthesis- related complications are still common. Outcome is strongly related to the patient's preoperative cardiac condition and to the adequacy of anticoagulation control.