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The St. Jude valve prosthesis: analysis of the clinical results in 815 implants and the need for systemic

M L Myers1, G M Lawrie, E S Crawford

  • 1Cora and Webb Mading Department of Surgery, Baylor College of Medicine, Houston, Texas 77030.

Journal of the American College of Cardiology
|January 1, 1989
PubMed

Insights

St. Jude Medical valve prostheses showed excellent results. Long-term warfarin anticoagulation is essential to prevent thromboembolic complications, as antiplatelet agents alone were insufficient.

Area of Science:

  • Cardiovascular Surgery
  • Biomaterials Science

Background:

  • Mechanical heart valves are crucial for treating valvular heart disease.
  • The St. Jude Medical valve prosthesis is a widely used option.

Purpose of the Study:

  • To evaluate the long-term clinical outcomes of St. Jude Medical valve prostheses.
  • To assess valve-related complications and the efficacy of anticoagulation strategies.

Main Methods:

  • Retrospective analysis of 785 patients who received 815 St. Jude Medical valve prostheses between 1979 and 1984.
  • Follow-up data collected to assess mortality, thromboembolism, hemorrhage, and reoperation rates.
  • Comparison of thromboembolic event rates across different anticoagulation therapies (warfarin, antiplatelet, none).

Main Results:

  • Excellent 3-year freedom from valve-related death or reoperation: 96.4% (aortic) and 98.3% (mitral).
  • Valve-related mortality included thromboembolism (7), hemorrhage (3), and perivalvular leak (2).
  • Thromboembolism rates: 2.6%/patient-year (warfarin), 9.2%/patient-year (antiplatelet), 15.6%/patient-year (none).

Conclusions:

  • St. Jude Medical valve replacement offers excellent clinical results.
  • Long-term warfarin anticoagulation is necessary to minimize thromboembolic risks.
  • Antiplatelet therapy alone is inadequate for preventing thromboembolic complications with this prosthesis.

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