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The Journal of Thoracic and Cardiovascular Surgery, Vol 92, 349-360, Copyright © 1986 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
RH Kinsley, MJ Antunes and PR Colsen
St. Jude Medical cardiac valve replacement was performed in 791 patients:
335 had aortic, 330 mitral, and 126 had multiple valve replacements.
Follow-up extended from 4 to 64 months (mean 34 months) with a cumulative
postoperative survival of 2,111 patient-years. The overall actuarial
survival rate at 5 years was 76% +/- 3%. Late valve- related mortality
occurred in 28 patients (1.33%/pt-yr) and was most often caused by
anticoagulant-related hemorrhage. The linearized incidences of valve
failure, thromboembolism, thrombotic obstruction, prosthetic valve
endocarditis, periprosthetic leak, and all valve- related complications
were as follows: 1.80% /pt-yr, 2.45% /pt-yr, 0.52% /pt-yr, 0.33% /pt-yr,
0.14% /pt-yr, and 4.0% /pt-yr, respectively. Actuarially, 94% +/- 2% of
patients were free of valve- related mortality at 5 years; the
corresponding figures for valve failure, thromboembolism, thrombotic
obstruction, and all valve-related complications were 91% +/- 2%, 89% +/-
2%, 96% +/- 1%, and 83% +/- 3%, respectively. Prosthetic valve endocarditis
was uniformly fatal, and 45% of patients with thrombotic obstruction died.
The greater incidence of thrombotic obstruction after mitral valve
replacement was statistically significant. The performance of the St. Jude
Medical valve compares most favorably with other substitute valves.
Nevertheless, it retains all the imperfections and hazards of other
mechanical valves, most notably, thromboembolism and thrombotic
obstruction.
ARTICLES
St. Jude Medical valve replacement. An evaluation of valve performance
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