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KMID : 0364019950280030258
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Korean Journal of Thoracic and Cardiovascular Surgery
1995 Volume.28 No. 3 p.258 ~ p.262
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Clinical Results of the St. Jude Medical Valve in Aortic Position
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Abstract
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A total and consecutive 87 patients underwent aortic valve replacement (AVR) with the St. Jude Medical prosthesis between 1984 and 1993. Age ranged from 14 to 66 years (mean: 38.6*14.0 years). Twenty-one patients 924.1%) had undergone previous
valve
replacement.
There were 8 early deaths with an operative mortality rate of 9.2% (7.6% for primary AVR and 14.3% for re-replacement AVR). Seventy-nine early survivors were followed for a total of 30.9.1 patient-years(mean:3.9*2.5 years). A late mortality rate
was
5.1% (4 patients) or a linearized incidence of 1.294%/patient-year. All were anticoagulated with coumadin to maintain the international normalized ratio (INR) between 1.5 and 2.5 One patient experienced thromboembolism (0.324%/patient-year), and
none
did bleeding. Endocarditis occurred in one (0.324%/patient-year). Paravalvular leak was the most frequent complication and was experienced by 8 patients (2.588%/patient-year), and 5 of them required re-replacement AVR (1.618%/patient year of
reoperation
rate). There was no structural failure of the prosthesis. Actuarial survival including operative death was 83.9%*4.6% at 10 years. The actuarial estimates of freedom from thromboembolism and of freedom from late death and all complications were
95.1%*4.8% and 81.4%*6.1%, respectively, at 10 years.
These clinical results suggest that less intensive anticoagulation may be allowed for patients of AVR with the St. Jude Medical valve with low incidences of both thromboembolic and bleeding complications.
(Korean J Thorac Cardiovasc Surg 1995;28:258-62)
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