[Clinical experience with the Saint Jude prosthesis. Results over a period of 7 years]

Between January, 1979 and December, 1985, 193 Saint Jude medical valves (SJM) were implanted in 165 patients (74 male, 91 female) aged from 14 to 78 years (mean age: 49 years). 101 patients underwent aortic valve replacement, 36 had mitral valve replacement and 21 had multiple valve replacement. Fitting with an SJM prosthesis was a primary emergency operation for 15 patients (9%) and a reoperation for 49 patients (31%). A concomitant surgical procedure was carried out in 39 patients (24%). The overall peri-operative mortality rate was 9% (15 patients), this figure falling to 5% (6/112 patients) when emergency surgery and reoperations are excluded. No patient was lost sight of. Mean follow-up was 37 +/- 3 months (range: 4 to 84 months), for a total duration of 413 years/patient. Five patients died of heart disease during the follow-up period, representing a mortality rate of 1.2% per year/patient. The actual survival rate was calculated as 90% at 1 year and 83% at 7 years. During that period 7 thromboembolic accidents occurred among 5 patients (actual rate: 1.7 accident per 100 years/patient). Two mechanical valve desinsertions requiring reoperation were recorded. Altogether, the actuarial rate of patients without any post-operative complication was 88% at 1 year and 65% at 7 years. Functional improvement was dramatic since 94% of survivors are now in class I or II, whilst 67% of patients were in class III or IV prior to surgery. It may be concluded that the mid-term