A Seven-Year Experience with the St. Jude Medical® Heart Valve
From May 1979 to October 1986, 442 ST. JUDE MEDICAL® valves (175 aortic, 142 mitral, and 61 multiple valve replacements) were inserted in 378 patients, ages 5 to 82 years. The operative mortality rates (30-day) were 1.1% aortic, 4.2% mitral, and 8.2% multiple valve replacement; and the late mortality was 6.8% aortic, 6.3% mitral, and 1.6% multiple valve replacement. All patients were anticoagulated. Three hundred seventy-eight patients have been followed for a total of 912 patient-years. During that time we have not recorded a single occurrence of primary structural failure or significant hemolysis in any patient. One aortic valve patient stopped taking her anticoagulant and the valve thrombosed; it was successfully replaced. In another patient, the mitral valve thrombosed after she switched from warfarin to subcutaneous heparin when she became pregnant; this valve was also successfully replaced. Twenty-four patients experienced isolated thromboembolic episodes (13 major, 11 minor)—an incidence of 2.7% per patient-year (2.6% aortic, 2.8% mitral, and 2.3% multiple). Included in the group were 9 children aged 5 to 16 years, 7 with mitral valve implants and 2 with aortic valve implants. One 9-year-old child who had an aortic valve implant for acute bacterial endocarditis died 2 months postoperatively with multiple organ failure. The remaining 8 patients, all on anticoagulation, continue to make excellent progress, 1 to 6 years later.
KeywordsAortic Valve Mitral Valve Valve Replacement Aortic Valve Replacement Prosthetic Valve
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