Twenty-five year experience with the St. Jude medical mechanical valve prosthesis

Ann Thorac Surg. 2010 May;89(5):1402-9. doi: 10.1016/j.athoracsur.2010.01.045.

Abstract

Background: We evaluated all adult St. Jude mechanical valve recipients at our institution since the initial implant in January 1979 and now present our 25-year experience.

Methods: Nine hundred forty-five valve recipients were followed prospectively at 12-month intervals from January 1979 to December 2007.

Results: Operative mortality was 3% in the aortic valve recipients and 5% in the mitral valve recipients. Follow-up was 95% complete. Among aortic valve recipients, late actuarial survival was 81% +/- 2%, 59% +/- 2%, 41% +/- 3%, 28% +/- 3%, and 17% +/- 4% at 5, 10, 15, 20, and 25 years, respectively. Twenty-five-year freedom from reoperation, thromboembolism, bleeding, and endocarditis was 90% +/- 2%, 69% +/- 5%, 67% +/- 3%, and 9% 3 +/- 2% respectively. Among mitral valve recipients late actuarial survival was 84% +/- 2%, 63% +/- 3%, 44% +/- 3%, 31% +/- 3%, and 23% +/- 4% at 5, 10, 15, 20, and 25 years, respectively. Twenty-five-year freedom from reoperation, thromboembolism, bleeding and endocarditis was 81% +/- 10%, 52% +/- 8%, 64% +/- 6%, and 97% +/- 1%. Freedom from valve-related mortality and morbidity at 25 years was 26% +/- 7% and 29% +/- 6% for aortic and mitral valve replacement, respectively. Freedom from valve-related mortality was 66% +/- 8% and 87% +/- 3% for aortic and mitral valve replacement, respectively.

Conclusions: These results compare favorably with those for other mechanical prostheses. After two and a half decades of observation with close follow-up, the St. Jude mechanical valve continues to be a reliable prosthesis.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Aortic Valve / surgery*
  • Bioprosthesis*
  • Cohort Studies
  • Confidence Intervals
  • Female
  • Follow-Up Studies
  • Heart Valve Diseases / surgery
  • Heart Valve Prosthesis Implantation / methods*
  • Heart Valve Prosthesis Implantation / mortality*
  • Heart Valve Prosthesis*
  • Humans
  • Male
  • Middle Aged
  • Mitral Valve / surgery*
  • Multivariate Analysis
  • Odds Ratio
  • Postoperative Complications / mortality
  • Probability
  • Proportional Hazards Models
  • Prospective Studies
  • Prosthesis Design
  • Prosthesis Failure
  • Risk Assessment
  • Survival Analysis
  • Time Factors
  • Treatment Outcome
  • Young Adult