[Ten-year experience with the St. Jude Medical valve replacement: comparison with the Björk-Shiley valve]

St. Jude Medical (SJM) valve replacement in 995 patients with a cumurative follow-up period of 2,730 patient-years was compared with the Björk-Shiley (BS) valve replacement in 406 patients, who had followed up for 3,779 patient-years (pt-yr). The overall survival rates of aortic, mitral, and double valve replacement with SJM (and BS) at 10 years were 60.6% (80.0%), 89.6% (81.9%), 90.3% (73.9%), respectively. The linealized incidences of thromboembolism, valve thrombosis, prosthetic valve endocarditis, anticoagulation-related hemorrhage, significant hemolysis, and structural failure in SJM (and BS) were as follows: 1.32%/pt-yr (0.82%/pt-yr), 0.11%/pt-yr (0.21%/pt-yr), 0.18%/pt-yr (0.08%/pt-yr), 0.04%/pt-yr (0.24%/pt-yr), 0.18%/pt-yr (0.13%/pt-yr), and 0%/pt-yr (0.05%/pt-yr), respectively. Reoperation (explant and re-replacement or suture repair) was required in 10 SJM patients (0.37%/pt-yr) and in 14 BS cases (0.37%/pt-yr). Actuarially over 97% of patients were free of valve-related mortality at 10 years in both groups. From these results we conclude that both SJM and BS valves are equally excellent cardiac valve prosthesis. Considering the better hemodynamic characteristics and technical feasibility, we have thus far adopted SJM, rather than BS, as a first prosthesis of choice.