A Comparison of St. Jude Medical® and Carpentier-Edwards® Xenograft Valves in the Mitral Position
This study compares the clinical results of patients receiving isolated mitral valve replacement with a ST. JUDE MEDICAL® prosthesis (SJM) or a CARPENTIER-EDWARDS® xenograft (CEX) over a period of 6.5 years. There were 85 patients (66 females and 23 males) with SJM valves, ages 5 to 70 years. Ninety four patients (63 females and 31 males), ages 29 to 71 years, had CEX valves implanted. Although the groups were not randomized, surgical techniques were comparable and myocardial protection was constant throughout the period. The CEX was used more frequently early in the study and, therefore, has a longer follow-up period (CEX: 301 patient-years; SJM: 207 patient-years). The 30-day mortality rate was 4.3% for CEX and 7% for SJM cases; late mortality was 8.5% in CEX and 5.9% in SJM patients. There were no reported cases of primary structural failure or significant hemolysis in either group. All patients in the SJM group and 80% in the CEX group were anticoagulated. Thromboembolic episodes occurred in 8 CEX patients, totaling 14 events (5 major, 9 minor), with a rate of 4.6% per patient-year. In the SJM group, 6 patients experienced isolated thromboembolic events (1 valve thrombosis, 2 major events, 3 minor), with a rate of 2.9% per patient-year. Thromboembolism resulted in 2 deaths in the CEX group and no deaths in the SJM group. Reoperation for paravalvular leaks was necessary in 5 patients (2 CEX, 3 SJM). While there were no cases of endocarditis in the SJM group, there were 3 (2 Q fever) in the CEX group with 1 death. The results in the two groups were similar in the number of patients alive and event-free at 6 years. Because of the known long-term failure rate of tissue values and the high percentage of tissue valves anticoagulated, our choice for mitral valve replacement is the ST. JUDE MEDICAL valve.
KeywordsMitral Valve Replacement Mitral Valve Repair Jude Medical Prosthetic Valve Endocarditis Paravalvular Leak
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