Affiliation:
1. From the Cardiovascular Surgery Unit and Department of Anesthesiology, G. and R. Laënnec University Hospital, Nantes, France.
Abstract
Background
—In this retrospective study, ≈440 patients received mitral valve replacements with the St Jude Medical prothesis. The last patient was operated on 10 years before the beginning of the follow-up. The extended follow-up was 19 years.
Methods and Results
—Four hundred forty patients (sex ratio, 1.32 [men to women]; age, 60±11.4 years; age range, 7 to 75 years) were operated on from 1979 to 1987. All patients underwent isolated mitral valve replacement. Tricuspid plasty was the only associated procedure. The follow-up at 19 years was 98% complete. The overall actuarial survival rate was 63±3.3% at 19 years, and the actuarial survival rate (only valve related) was 83±2.7%. The operative mortality rate (0 to 30 days) was 4.09%. We found that 89.4% of the patients alive at 19 years were in NYHA class I/II. Multivariate analysis showed that age and sex were significantly correlated with valve-related mortality and that age, sex, NYHA class, and atrial fibrillation were significantly correlated with overall mortality. The linearized rates (percent patient-years) of thromboembolism, thrombosis, and hemorrhage were 0.69, 0.2, and 1, respectively. At 19 years, freedom from endocarditis and reoperation was 98.6±1% and 90±3%, respectively.
Conclusions
—In this study, the very-long-term results confirm the excellent durability of the St Jude Medical prosthesis in the mitral position and show the difficulty of adjusting the anticoagulation protocol, even after long-term treatment.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Physiology (medical),Cardiology and Cardiovascular Medicine
Reference15 articles.
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