Durability and Low Thrombogenicity of the St. Jude Medical® Heart Valve: Long-Term Follow-Up

  • D. A. Cooley


From November 1978 through December 1986, 1953 patients underwent valve replacement at the Texas Heart Institute with the ST. JUDE MEDICAL® cardiac valve prosthesis. Aortic valve replacement (AVR) was done in 1203 patients, mitral valve replacement (MVR) in 572 patients, and double valve replacement (AVR + MVR) in 178 patients. Of the total patients, 65.1% were men and 34.9% were women. The mean age of patients was 52.8 years (range 1–88 years): 52.2 y ears for patients having AVR, 54.0 years for patients having MVR, and 53.4 years for patients having AVR + MVR. There were 619 associated procedures performed. Eighty-three percent of patients were in New York Heart Association (NYHA) Functional Classes HI or IV preoperatively. Total follow-up was 3106 patient-years with a maximum of 99 months (mean 19 months). The early mortality rate (within 30 days) for the entire series of patients was 7.5%. The early mortality rate was lowest inpatients undergoing isolated procedure. The total early mortality rate for AVR was 5.7%; for MVR, 8.9%; and for AVR + MVR, 14.6%, reflecting the severity of disease inpatients requiring double valve replacement. The 7-year actuarial survival rate was 84.9% for AVR, 81.0% for MVR, and 78.7% for patients who underwent AVR + MVR. Few valve-related complications occurred. There were no instances of structural valve failure. Postoperatively, 98.3% of patients were in NYHA Functional Classes I or II, compared with only 17.1% in these two classes preoperatively. In all respects, the ST. JUDE MEDICAL valve proved superior to other mechanical valves. The valve has good hemodynamic characteristics, has a low incidence of thromboembolism, and is durable. It has a low profile and is easily inserted, even in the small aortic root. We currently favor this valve in all patients unless there is a specific contraindication to long-term anticoagulation.


Valve Replacement Aortic Valve Replacement Mitral Valve Replacement Mechanical Valve Jude Medical 
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  1. 1.
    Emery RW, Mettler E, Nicoloff DM. A new cardiac prosthesis: The St. Jude Medical cardiac valve: In vitro results. Circulation 1979; 60:48.PubMedGoogle Scholar
  2. 2.
    Emery RW, Nicoloff DM. St. Jude Medical cardiac valve prosthesis: In vitro studies. J Thorac Cardiovasc Surg 1979; 78:269.PubMedGoogle Scholar
  3. 3.
    Nicoloff DM, Emery RW. Current status of the St. Jude cardiac valve prosthesis. Contemp Surg 1979; 15:11.Google Scholar
  4. 4.
    Duncan JM, Cooley DA, Livesay JJ, et al. The St. Jude Medical valve: Early clinical results in 253 patients. Texas Heart Inst J 1983; 10:11.Google Scholar
  5. 5.
    Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. Am Stat Assoc J 1958; 53:457–481.CrossRefGoogle Scholar
  6. 6.
    Gehan EA. Generalized Wilcoxon test for comparing arbitrary single-censored samples. Biometrika 1965; 52:203.PubMedGoogle Scholar
  7. 7.
    Duncan JM, Cooley DA, Reul GJ Jr, et al. Durability and low thrombogenicity of the St. Jude Medical valve at 5-year follow-up. Ann Thorac Surg 1986; 42:505.CrossRefGoogle Scholar
  8. 8.
    Gray RJ. Hemodynamic function of St. Jude aortic valves: Comparison with a porcine and Björk-Shiley prosthesis. In DeBakey ME (ed): Advances in Cardiac Valves, Proceedings of the Third International Symposium on the St. Jude Medical Heart Valve. Yorke Medical Books, New York 1983; pp 247–258.Google Scholar
  9. 9.
    Wortham DC, Tri TB, Bowen TE, Hemodynamic evaluation of the St. Jude Medical valve prosthesis in the small aortic anulus. J Thorac Cardiovasc Surg 1981; 81:615.PubMedGoogle Scholar
  10. 10.
    Nicoloff DM, Emery RW, Arom KV, et al. Clinical and hemodynamic results with the St. Jude Medical cardiac valve prosthesis: A three-year experience. J Thorac Cardiovasc Surg 1981; 82:674.PubMedGoogle Scholar
  11. 11.
    Horstkotte D, Haerten K, Herzer JA, et al. Preliminary clinical and hemodynamic results after mitral valve replacement using St. Jude Medical prostheses in comparison with the Björk-Shiley valve. Thorac Cardiovasc Surg 1981; 29:93.PubMedCrossRefGoogle Scholar
  12. 12.
    Baudet EM, Oca CC, Roques XF, et al. A 5½ year experience with the St. Jude Medical valve: Hemodynamic performance, surgical results, biocompatibility and follow-up. JACC 1985; 6:904.Google Scholar
  13. 13.
    Czer LSC, Matloff JM, Chaux A, et al. A 6-year experience with the St. Jude Medical valve: Hemodynamic performance, surgical results, biocompatibility and follow-up. JACC 1985; 6:904.PubMedGoogle Scholar
  14. 14.
    Chandran KB. Pulsatile flow past St. Jude Medical bileaflet valve: An in vitro study. J Thorac Cardiovasc Surg 1985; 89:743.PubMedGoogle Scholar
  15. 15.
    Kawachi Y, Tokunaga K, Watanabe Y, et al. In vivo hemodynamics of prosthetic St. Jude Medical and Ionescu-Shiley heart valves analyzed by computer. Ann Thorac Surg 1985; 39:456.Google Scholar
  16. 16.
    Ribeiro PA, Al Zaibag M, Idris M, et al. Antiplatelet drugs and the incidence of thromboembolic complications of the St. Jude Medical aortic prosthesis in patients with rheumatic heart disease. J Thorac Cardiovasc Surg 1986; 91:92.PubMedGoogle Scholar
  17. 17.
    Sweeney MS, Reul GJ Jr, Cooley DA, et al. Comparison of bioprosthetic and mechanical valve replacement for active endocarditis. J Thorac Cardiovasc Surg 1985; 90:676.PubMedGoogle Scholar

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© Kluwer Academic Publishers 1989

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  • D. A. Cooley

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