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ASAIO CARDIAC ABSTRACT

LONG-TERM RESULTS WITH THE ST. JUDE MEDICAL HEART VALVE: A 25-YEAR EXPERIENCE

Joyce, L. D.1; Emery, R. W.2; Krogh, C.2; Arom, K. V.2; Nicoloff, D. M.2

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From 10/77-10/02, 4481 patients (age range 17–94 years, average age 64 ± 13) underwent single valve replacement with the St. Jude Medical (SJM) heart valve. Of 2983 aortic (AVR) and 1498 mitral valve replacements (MVR), concomitant coronary bypass was performed on 42% and 33% respectively. METHODS We have maintained an independent database of valve replacement patients since the world's first implant. Patients were contacted by questionnaire and/or phone from 11/02 through 6/03. Events were verified by patient chart review and/or physician contact. RESULTS: Follow-up was 95% complete: 50% active, 39% expired, 1% refused participation and 5% other. Operative mortality was 4% AVR and 9% MVR. Total follow-up was 32, 190 patient years (range 1 month to 24.8 years, average 7 ± 5 years). Over 25 years, patient freedom from late mortality was 61 % (AVR 61 %, MVR 63%), and from valve-related mortality 92% (AVR 93%, MVR 91%). Freedom from thromboembolic events was: 85% (86% AVR, 81 % MVR), from bleeding events: 81% (81% AVR, 81% MVR), from reoperation: 98% (99% AVR and 97% MVR), from endocarditis: 98% (99% AVR and 98% MVR), and from valve thrombosis: 99% (99% AVR and 98% MVR). There was 1 MVR prosthetic structural failure (.06%). The SJM valve has proven to be an effective, durable heart valve prosthesis with a low-event rate over the long term.

Copyright © 2004 by the American Society for Artificial Internal Organs