HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Antunes, M. J. Articles by Fernandes, L. E. Search for Related Content PubMed PubMed Citation Articles by Antunes, M. J. Articles by Fernandes, L. E.

The Journal of Thoracic and Cardiovascular Surgery, Vol 95, 980-993, Copyright © 1988 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Medtronic Hall valve replacement in a third-world population group. A review of the performance of 1000 prostheses

MJ Antunes, A Wessels, RG Sadowski, JG Schutz, KM Vanderdonck, JM Oliveira and LE Fernandes
Division of Cardiothoracic Surgery, Johannesburg Group of Teaching Hospitals, Republic of South Africa.

Between May 1980 and December 1984, 1000 Medtronic Hall prostheses (538 mitral and 462 aortic) were implanted in 852 patients (mean age 30 +/- 15 years) of a third-world type of population group. The most common valve lesions were aortic and mitral regurgitation, and 32% of the patients were in New York Heart Association class IV or greater. Double valve (aortic and mitral) operations were performed in 209 patients. The 782 operative survivors were followed up for 2 to 6.5 years (mean 3.5 years) for a cumulative 2676 patient-years. Valve performance was analyzed in each position separately for valve-related complications. Results for the whole group for the following events are expressed in both linearized (percent/patient-year) and actuarial (percent +/- standard error of the mean freedom at 5 years) terms, respectively: valve-related mortality, 2.9 and 92 +/- 2; reoperation, 1.9 and 90 +/- 2; systemic thromboembolism, 3.3 and 85 +/- 2; thrombotic obstruction, 1.2 and 95 +/- 1; prosthetic valve endocarditis, 0.7 and 97 +/- 1; anticoagulant-related hemorrhage, 0.7 and 98 +/- 1; and periprosthetic leak, 0.7 and 97 +/- 1. Corresponding composite figures for valve failure were 4.3 and 85 +/- 2, and for all valve-related morbidity and mortality were 6.7 and 75 +/- 3. Thrombotic obstruction (fatal in 71% of the cases), anticoagulant-related hemorrhage (61% fatal), and prosthetic endocarditis (44% fatal) were the most lethal complications. Although the differences did not reach statistical significance, aortic prostheses appeared to have a higher incidence of complications than the mitral prostheses. When analyzed against the background of an essentially noncompliant population group, the Medtronic Hall prosthesis proved to be reliable and remarkably free from structural failure. The high incidence of thromboembolism and thrombotic obstruction still mandates anticoagulation.

This article has been cited by other articles:

				T. Gudbjartsson, T. Absi, and S. Aranki Mitral Valve Replacement Card. Surg. Adult, January 1, 2008; 3(2008): 1031 - 1068. [Full Text]

				V. T Nkomo Epidemiology and prevention of valvular heart diseases and infective endocarditis in Africa Heart, December 1, 2007; 93(12): 1510 - 1519. [Abstract] [Full Text] [PDF]

				T. Gudbjartsson, S. Aranki, and L. H. Cohn Mechanical/Bioprosthetic Mitral Valve Replacement Card. Surg. Adult, January 1, 2003; 2(2003): 951 - 986. [Full Text]

				A. C. Fiore, H. B. Barner, M. T. Swartz, L. R. McBride, A. J. Labovitz, K. J. Vaca, J. St. Vrain, G. L. Grunkemeier, and G. C. Kaiser Mitral valve replacement: randomized trial of St. Jude and Medtronic Hall prostheses Ann. Thorac. Surg., September 1, 1998; 66(3): 707 - 713. [Abstract] [Full Text] [PDF]

				C. E.E. Kuntze, E. H. Blackstone, and T. Ebels Thromboembolism and mechanical heart valves: a randomized study revisited Ann. Thorac. Surg., July 1, 1998; 66(1): 101 - 107. [Abstract] [Full Text] [PDF]

				T. E. David, V. L. Gott, L. A. Harker, G. E. Miller Jr, D. C. Naftel, A. G. G. Turpie, and C. W. Akins Mechanical Valves Ann. Thorac. Surg., November 1, 1996; 62(5): 1567 - 1570. [Full Text]

				C. W. Akins Results With Mechanical Cardiac Valvular Prostheses Ann. Thorac. Surg., December 1, 1995; 60(6): 1836 - 1844. [Abstract] [Full Text]

				R. G. Masters, A. L. Pipe, V. M. Walley, and W. J. Keon Comparative results with the St. Jude Medical and Medtronic Hall mechanical valves J. Thorac. Cardiovasc. Surg., September 1, 1995; 110(3): 663 - 671. [Abstract] [Full Text]

				M. Ibrahim, H. O'Kane, J. Cleland, D. Gladstone, M. Sarsam, and C. Patterson The St. Jude Medical prosthesisA thirteen-year experience J. Thorac. Cardiovasc. Surg., August 1, 1994; 108(2): 221 - 230. [Abstract] [Full Text]

				C.W. Akins Review of the global experience with the Medtronic-Hall valve Eur. J. Cardiothorac. Surg., January 1, 1992; 6(suppl_1): S68 - S74. [Abstract] [PDF]