[Long-term experience with multivalve replacement with the Medtronic-Hall mechanical prosthesis]

Area of Science:

• Cardiovascular Surgery
• Biomedical Engineering
• Prosthetic Heart Valves

Context:

• Rheumatic valve disease is a primary indication for heart valve replacement.
• Mechanical heart valves are widely used for long-term hemodynamic support.
• Patient outcomes following valve replacement are influenced by prosthesis type and patient comorbidities.

Purpose:

• To evaluate the clinical performance and mechanical reliability of the Medtronic-Hall (M-H) heart valve prosthesis.
• To assess long-term survival, thromboembolism, endocarditis, and complication rates following M-H valve implantation.
• To compare outcomes between aortic/mitral valve replacement (Group I) and tricuspid valve replacement (Group II).

Summary:

• 182 Medtronic-Hall (M-H) valves were implanted in 89 patients (Group I: 83 patients, aortic/mitral; Group II: 6 patients, tricuspid +/- others).
• Hospital mortality was 6.02% (Group I) and 33.3% (Group II).
• At 8 years, Group I showed actuarial survival of 72.7%, freedom from thromboembolism of 85.8%, and freedom from endocarditis of 93.1%. No structural failures occurred; complications included hemorrhage (6), hemolysis (8), and periprosthetic leaks (2).

Impact:

• The M-H valve prosthesis exhibits excellent clinical performance and mechanical reliability over an 8-year follow-up period.
• The incidence of valve-related complications is comparable to other mechanical prostheses, suggesting favorable long-term outcomes.
• Findings support the M-H valve as a reliable option for patients requiring cardiac valve replacement, particularly for rheumatic valve disease.