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St. Jude prosthesis for aortic and mitral valve replacement: a ten-year experience
J M Kratz1, F A Crawford, R M Sade
1Division of Cardiothoracic Surgery, Medical University of South Carolina, Charleston 29425.
The Annals of Thoracic Surgery
|September 1, 1993
Summary
This study evaluated the long-term outcomes of St. Jude valve replacement for aortic (AVR) and mitral (MVR) valve surgeries. Results show improved functional class and survival rates, with manageable thromboembolic complication risks for both AVR and MVR patients.
Area of Science:
- Cardiovascular Surgery
- Prosthetic Heart Valves
- Clinical Outcomes Research
Background:
- The St. Jude prosthesis is a widely used mechanical heart valve for aortic and mitral valve replacement.
- Long-term data on survival and complications following these procedures are crucial for patient management and surgical decision-making.
Purpose of the Study:
- To assess the long-term efficacy and safety of the St. Jude prosthesis in adult patients undergoing isolated aortic valve replacement (AVR) or mitral valve replacement (MVR).
- To evaluate survival rates, thromboembolic complications, and functional status improvement after AVR and MVR.
Main Methods:
- Retrospective analysis of 456 adult patients who underwent isolated AVR (n=254) or MVR (n=202) with the St. Jude prosthesis between 1979 and 1990.
- Data collection included patient demographics, perioperative characteristics, in-hospital outcomes, and long-term follow-up (94.5% complete).
- Outcomes assessed included mortality, thromboembolic events, and New York Heart Association (NYHA) functional class.
Main Results:
- Actuarial survival at 5 years was approximately 80% for both AVR and MVR groups, decreasing to 47% (AVR) and 63% (MVR) at 10 years.
- Thromboembolic complication rates were 1.8%/patient-year for AVR and 2.9%/patient-year for MVR, with 10-year freedom from events at 67% and 77%, respectively.
- Significant improvement in NYHA functional class was observed post-operatively for both groups (mean 3.1 to 1.6, p < 0.0001).
Conclusions:
- The St. Jude prosthesis provides good long-term survival and functional improvement for patients undergoing aortic and mitral valve replacement.
- While thromboembolic complications occur, the rates are manageable, and long-term freedom from these events is achievable.
- These findings support the continued use of the St. Jude prosthesis in selected patient populations.