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The St. Jude "Silzone" valve: midterm results in treatment of active endocarditis

R G Seipelt1, J F Vazquez-Jimenez, I M Seipelt

  • 1Department of Thoracic and Cardiovascular Surgery, University Hospital RWTH, Aachen, Germany. rseipelt@post.klinikum.rwth-aachen.de

The Annals of Thoracic Surgery
|September 22, 2001
PubMed
Abstract

Insights

The St. Jude Medical "Silzone" valve showed no benefit in preventing prosthetic valve endocarditis (PVE) in active endocarditis patients. A high rate of paravalvular leaks requiring reoperation was observed.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Infectious Diseases

Background:

  • The St. Jude Medical
  • Silzone
  • valve was designed to reduce prosthetic valve endocarditis (PVE).
  • It was recalled due to an increased incidence of paravalvular leaks.

Purpose of the Study:

  • To assess the efficacy of the SJM
  • Silzone
  • valve in preventing PVE.
  • To evaluate the frequency of paravalvular leaks when used in active bacterial endocarditis.

Main Methods:

  • Implantation of SJM
  • Silzone
  • valves in 40 consecutive patients with active endocarditis (1998-1999).
  • Echocardiography (transesophageal and transthoracic) for follow-up.
  • 100% patient follow-up.

Main Results:

  • Hospital mortality was 17.5%.
  • Early PVE occurred in 5% of patients.
  • Clinically significant paravalvular leaks requiring reoperation occurred in 2 patients within 6 months.
  • Minor paravalvular leaks were observed in 13% of patients.

Conclusions:

  • The SJM
  • Silzone
  • valve did not offer improved outcomes for PVE prevention in active endocarditis compared to other mechanical valves.
  • The rate of hemodynamically significant paravalvular leaks was notably high.
  • Minor paravalvular leak rates were comparable to other mechanical prostheses.

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