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The St. Jude Medical valve. Experience with 1,000 cases
1Division of Cardiothoracic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048.
The Journal of Thoracic and Cardiovascular Surgery
|December 1, 1994
Summary
Long-term St. Jude Medical valve replacement shows excellent freedom from valve issues. However, patient age and coronary disease significantly limit overall survival, not the artificial heart valve itself.
Area of Science:
- Cardiovascular Surgery
- Biomaterials Science
- Clinical Outcomes Research
Background:
- The St. Jude Medical bileaflet valve has been widely used for heart valve replacement.
- Long-term outcomes data are crucial for understanding the durability and patient impact of prosthetic valves.
Purpose of the Study:
- To evaluate the long-term results of heart valve replacement using the St. Jude Medical bileaflet valve.
- To identify factors influencing survival and complications after valve replacement surgery.
Main Methods:
- Retrospective analysis of the first 1000 St. Jude Medical bileaflet valve implantations (1978-1992).
- Follow-up data collected over 4328 patient-years.
- Analysis of thromboembolism, hemorrhage, valve-related death, and overall survival rates.
Main Results:
- At 10 years, freedom from thromboembolism ranged from 76-83%, and freedom from valve-related hemorrhage was 82-87%.
- Freedom from valve-related death at 10 years was high (84-91%).
- Overall survival at 10 years was significantly lower (42-43%), with age and coronary disease being major predictors of mortality.
Conclusions:
- The St. Jude Medical bileaflet valve demonstrates excellent performance regarding valve-related complications and death.
- Long-term survival after valve replacement is primarily limited by patient-specific factors like advanced age and comorbid coronary disease, rather than the prosthetic valve itself.