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The St. Jude prosthetic heart valve demonstrated a low complication rate in 91 patients undergoing aortic and mitral valve replacement. Survival rates were high, indicating the St. Jude valve is a competitive option for cardiac valve surgery.
Area of Science:
- Cardiovascular Surgery
- Biomaterials Science
- Clinical Outcomes Research
Background:
- Prosthetic heart valves are crucial for treating valvular heart disease.
- The St. Jude mechanical valve is a widely used option.
- Evaluating long-term outcomes and complication rates is essential for patient management.
Purpose of the Study:
- To report the clinical experience with the St. Jude prosthetic heart valve.
- To assess complication rates and survival following aortic and mitral valve replacement.
- To compare the St. Jude valve's performance against other mechanical valves.
Main Methods:
- Retrospective analysis of 91 patients undergoing aortic or mitral valve replacement.
- Data collection on complications (hemorrhage, thromboembolism, infection, etc.) and mortality.
- Survival analysis at 3.8 years post-operation.
- Warfarin anticoagulation management for all patients.
Main Results:
- Overall mortality was 7% (5% excluding non-cardiac deaths).
- Annual complication rates for nonfatal events were low (e.g., thromboembolism 0.87%/100 patient-years).
- 3.8-year survival rates were 89% for mitral and 93% for aortic valve replacement, with an overall 92% survival.
Conclusions:
- The St. Jude prosthetic heart valve exhibits a low complication rate comparable to or better than other mechanical valves.
- High survival rates and functional outcomes (83% NYHA Class I) support its efficacy.
- The valve is a safe and effective option for patients requiring aortic and mitral valve replacement.
Abstract:
This paper covers our experience with the use of the St. Jude prosthetic heart valve from November 1979 through August 1983 in 91 patients operated on for aortic and mitral valve replacement. Nonfatal complications included hemorrhagic sequela due to anticoagulation, with an annual rate of 1 percent (1.4 percent per 100 patient years), thromboembolism with an annual rate of 0.8 percent (0.87 percent per 100 patient years), sternal infection 1 percent, operative cardiovascular accident 1 percent, and pericardial tamponade 1 percent. Operative mortality was 1 percent, early mortality (within 30 days) was 3 percent, and late mortality was 3 percent, with a total overall mortality of 7 percent. Excluding two patients who died from noncardiac causes, the overall mortality was 5 percent. The mortality rate per year was 2 percent. The survival rate 3.8 years postoperatively was 89 percent for mitral valve replacement patients and 93 percent for aortic valve replacement patients, for an overall 38 year survival rate of 92 percent. All patients were anticoagulated with warfarin. There were no instances of valve failure, replacement, or serious hemolysis. Eighty-three percent were active or working with a New York heart functional class I. In our experience, the complication rate with the St. Jude valve is as low or lower than that for any other mechanical prosthetic cardiac valve available in the world today.