HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Czer, L. S. Articles by Blanche, C. Search for Related Content PubMed PubMed Citation Articles by Czer, L. S. Articles by Blanche, C.

The Journal of Thoracic and Cardiovascular Surgery, Vol 100, 44-54, Copyright © 1990 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Ten-year experience with the St. Jude Medical valve for primary valve replacement

LS Czer, A Chaux, JM Matloff, MA DeRobertis, SA Nessim, D Scarlata, SS Khan, RM Kass, TP Tsai and C Blanche
Department of Thoracic and Cardiovascular Surgery, Cedars-Sinai Medical Center, Los Angeles, Calif 90048.

The St. Jude Medical valve is a bileaflet prosthesis with excellent hemodynamic characteristics, but the long-term surgical experience with this valve, its durability, and its biocompatibility are unknown. During a 10-year period from March 1978 to 1988, 690 prostheses (290 aortic, 252 mitral, and 74 double aortic-mitral) were inserted as the initial valve replacement substitute in 616 patients (mean age 63 years). Coronary atherosclerosis was present in 58%. Follow-up totaled 2031 patient-years (mean 3.3 years) and was 95% complete (32 lost). Early (30-day) mortality rates were 5.2%, 11.9%, and 8.1% after aortic, mitral, and double valve replacement; 5- and 9-year actuarial survival rates were 71% +/- 3% and 51% +/- 8%, 59% +/- 4% and 41% +/- 6%, and 69% +/- 6% and 47% +/- 15%, respectively. Deaths were associated with extensive coronary atherosclerosis (p less than 0.001), older age (p less than 0.001), advanced preoperative New York Heart Association functional class (p less than 0.05), and malignant ventricular arrhythmias (p less than 0.05). No structural failures have been observed. Embolism (40 events) occurred at a rate of 2.0%/pt-yr (2.3% aortic, 1.6% mitral, 2.0% double). There were six cases of valve thrombosis (0.3%/pt-yr; one fatal). Hemorrhage was the most frequent complication (2.6%/pt-yr); 13 (25%) of 52 events were fatal, accounting for 62% of all valve-related deaths. After the target prothrombin time ratio was lowered, the rate of hemorrhage decreased by 44% (2.7% to 1.5%/pt-yr), while the combined rate of embolism and valve thrombosis increased slightly (2.2% to 2.5%/pt-yr, a 14% change). In summary, the St. Jude Medical valve remains a durable valve substitute. Survival was strongly related to the presence of associated coronary atherosclerosis. The most common complication has been hemorrhage; a less intensive warfarin regimen may reduce hemorrhagic risk while maintaining thromboembolic protection.

This article has been cited by other articles:

				T. Gudbjartsson, T. Absi, and S. Aranki Mitral Valve Replacement Card. Surg. Adult, January 1, 2008; 3(2008): 1031 - 1068. [Full Text]

				S. Goland, L. S.C. Czer, M. A. De Robertis, J. Mirocha, R. M. Kass, G. P. Fontana, W. Chang, and A. Trento Risk Factors Associated With Reoperation and Mortality in 252 Patients After Aortic Valve Replacement for Congenitally Bicuspid Aortic Valve Disease Ann. Thorac. Surg., March 1, 2007; 83(3): 931 - 937. [Abstract] [Full Text] [PDF]

				C. H. Kang, H. Ahn, K. H. Kim, and K.-B. Kim Long-Term Result of 1144 CarboMedics Mechanical Valve Implantations Ann. Thorac. Surg., June 1, 2005; 79(6): 1939 - 1944. [Abstract] [Full Text] [PDF]

				R. Hiratsuka, S. Fukunaga, E. Tayama, K. Takagi, K. Arinaga, T. Shojima, H. Teshima, and S. Aoyagi High-intensity transient signals due to prosthetic valve obstruction: diagnostic and therapeutic implications Ann. Thorac. Surg., May 1, 2004; 77(5): 1615 - 1621. [Abstract] [Full Text] [PDF]

				J. S. Ikonomidis, J. M. Kratz, A. J. Crumbley III, M. R. Stroud, S. M. Bradley, R. M. Sade, and F. A. Crawford Jr Twenty-year experience with the St Jude Medical mechanical valve prosthesis J. Thorac. Cardiovasc. Surg., December 1, 2003; 126(6): 2022 - 2031. [Abstract] [Full Text] [PDF]

				J.B. Borman and C. De Riberolles Sorin BicarbonTM bileaflet valve: a 10-year experience Eur. J. Cardiothorac. Surg., January 1, 2003; 23(1): 86 - 92. [Abstract] [Full Text] [PDF]

				T. Gudbjartsson, S. Aranki, and L. H. Cohn Mechanical/Bioprosthetic Mitral Valve Replacement Card. Surg. Adult, January 1, 2003; 2(2003): 951 - 986. [Full Text]

				G. Cohen, G. T. Christakis, C. D. Joyner, C. D. Morgan, M. Tamariz, N. Hanayama, H. Mallidi, J.P. Szalai, M. Katic, V. Rao, et al. Are stentless valves hemodynamically superior to stented valves? A prospective randomized trial Ann. Thorac. Surg., March 1, 2002; 73(3): 767 - 778. [Abstract] [Full Text] [PDF]

				Y. Soga, H. Okabayashi, T. Nishina, S. Enomoto, I. Shimada, T.-A. Miyamoto, and T. Ban Up to 8-year follow-up of valve replacement with CarboMedics valve Ann. Thorac. Surg., February 1, 2002; 73(2): 474 - 479. [Abstract] [Full Text] [PDF]

				P. Groves VALVE DISEASE: Surgery of valve disease: late results and late complications Heart, December 1, 2001; 86(6): 715 - 721. [Full Text] [PDF]

				N. Vitale, I. Caldarera, C. Muneretto, R. Sinatra, A. Scafuri, E. Di Rosa, A. Contini, N. Tedesco, A. Pierangeli, M. Abbate, et al. Clinical evaluation of St Jude Medical Hemodynamic Plus versus standard aortic valve prostheses: The Italian multicenter, prospective, randomized study J. Thorac. Cardiovasc. Surg., October 1, 2001; 122(4): 691 - 698. [Abstract] [Full Text] [PDF]

				K. Ananthasubramaniam, J. N. Beattie, H. S. Rosman, V. Jayam, and S. Borzak How Safely and for How Long Can Warfarin Therapy Be Withheld in Prosthetic Heart Valve Patients Hospitalized With a Major Hemorrhage? Chest, February 1, 2001; 119(2): 478 - 484. [Abstract] [Full Text] [PDF]

				S. K. Choudhary, A. Mathur, P. Venugopal, B. Airan, R. Sharma, A. Bhan, A. Saxena, A. Sampath Kumar, S. K. Choudhary, A. Mathur, et al. Prosthesis Size in Aortic Valve Replacement: Surgeon-Related Variable Asian Cardiovasc Thorac Ann, December 1, 2000; 8(4): 333 - 338. [Abstract] [Full Text] [PDF]

				S. Aoyagi, M. Nishimi, H. Kawano, E. Tayama, S. Fukunaga, N. Hayashida, H. Akashi, and T. Kawara Obstruction of st jude medical valves in the aortic positionSignificance of a combination of cineradiography and echocardiography J. Thorac. Cardiovasc. Surg., July 1, 2000; 120(1): 142 - 147. [Abstract] [Full Text] [PDF]

				M. J.R. Dalrymple-Hay, R. Pearce, S. Dawkins, M. P. Haw, R. K. Lamb, S. A. Livesey, and J. L. Monro A single-center experience with 1,378 CarboMedics mechanical valve implants Ann. Thorac. Surg., February 1, 2000; 69(2): 457 - 463. [Abstract] [Full Text] [PDF]

				J. J.M. Takkenberg, T. A. Denton, R. Baak, A. Trento, E. W. Steyerberg, and L. A. van Herwerden CORONARY ARTERY BYPASS GRAFTING AFTER PRIMARY ISOLATED AORTIC VALVE SURGERY J. Thorac. Cardiovasc. Surg., November 1, 1999; 118(5): 958 - 959. [Full Text] [PDF]

				J. L. Zellner, J. M. Kratz, A. J. Crumbley III, M. R. Stroud, S. M. Bradley, R. M. Sade, and F. A. Crawford Jr Long-term experience with the St. Jude medical valve prosthesis Ann. Thorac. Surg., October 1, 1999; 68(4): 1210 - 1218. [Abstract] [Full Text] [PDF]

				M. Ura, R. Sakata, Y. Nakayama, and H. Fukui Bileaflet mechanical valve (St. Jude Medical valve) replacement in long-term dialysis patients Ann. Thorac. Surg., September 1, 1999; 68(3): 870 - 873. [Abstract] [Full Text] [PDF]

				S. Torregrosa, J. Gomez-Plana, F. J. Valera, J. Caffarena, J. M. Maronas, F. Garcia-Sanchez, J. Peris, R. Frias, and J. M. Caffarena Long-term clinical experience with the omnicarbon prosthetic valve Ann. Thorac. Surg., September 1, 1999; 68(3): 881 - 886. [Abstract] [Full Text] [PDF]

				J.B. Borman, W.G.B. Brands, L. Camilleri, M. Cotrufo, W. Daenen, I. Gandjbakhch, C. Infantes, A. Khayat, F. Laborde, A. Pellegrini, et al. Bicarbon valve - European multicenter clinical evaluation Eur. J. Cardiothorac. Surg., June 1, 1999; 13(6): 685 - 693. [Abstract] [Full Text] [PDF]

				A. Tasdelen, C. Ikizler, S. Aslamaci, A. Yavari, E. Ekici, and G. Arslan Three-Year Experience With the Ultracor Valve Prosthesis Asian Cardiovasc Thorac Ann, December 1, 1998; 6(4): 265 - 269. [Abstract] [Full Text] [PDF]

				X. M. Mueller, H. T. Tevaearai, F. Stumpe, A. P. Fischer, M. Hurni, P. Ruchat, and L. v. Segesser Long-term results of mitral-aortic valve operations J. Thorac. Cardiovasc. Surg., June 1, 1998; 115(6): 1298 - 1302. [Abstract] [Full Text] [PDF]

				K. E. Sommers and T. E. David Aortic Valve Replacement With Patch Enlargement of the Aortic Annulus Ann. Thorac. Surg., June 1, 1997; 63(6): 1608 - 1612. [Abstract] [Full Text]

				D. Sawant, A. K. Singh, W. C. Feng, A. A. Bert, and F. Rotenberg Nineteen-Millimeter Aortic St. Jude Medical Heart Valve Prosthesis: Up to Sixteen Years' Follow-up Ann. Thorac. Surg., April 1, 1997; 63(4): 964 - 970. [Abstract] [Full Text]

				S. M. Rodler, A. Moritz, W. Schreiner, A. End, P. Dubsky, and E. Wolner Five-Year Follow-up After Heart Valve Replacement With the CarboMedics Bileaflet Prosthesis Ann. Thorac. Surg., April 1, 1997; 63(4): 1018 - 1025. [Abstract] [Full Text]

				M. R. Aupart, P. H. Neville, S. Hammami, A. L. Sirinelli, Y. A. Meurisse, and M. A. Marchand CARPENTIER-EDWARDS PERICARDIAL VALVES IN THE MITRAL POSITION: TEN-YEAR FOLLOW-UP J. Thorac. Cardiovasc. Surg., March 1, 1997; 113(3): 492 - 498. [Abstract] [Full Text]

				D. Sawant, A. K. Singh, W. C. Feng, A. A. Bert, and F. Rotenberg ST. JUDE MEDICAL CARDIAC VALVES IN SMALL AORTIC ROOTS: FOLLOW-UP TO SIXTEEN YEARS J. Thorac. Cardiovasc. Surg., March 1, 1997; 113(3): 499 - 509. [Abstract] [Full Text]

				T. Abe, K. Kamata, K. Kuwaki, K. Komatsu, and S. Komatsu Ten Years' Experience of Aortic Valve Replacement With the Omnicarbon Valve Prosthesis Ann. Thorac. Surg., April 1, 1996; 61(4): 1182 - 1187. [Abstract] [Full Text]

				M. R. Aupart, A. L. Sirinelli, F. F. Diemont, Y. A. Meurisse, X. B. Dreyfus, and M. A. Marchand The Last Generation of Pericardial Valves in the Aortic Position: Ten-Year Follow-up in 589 Patients Ann. Thorac. Surg., February 1, 1996; 61(2): 615 - 620. [Abstract] [Full Text]

				R. G. Masters, A. L. Pipe, V. M. Walley, and W. J. Keon Comparative results with the St. Jude Medical and Medtronic Hall mechanical valves J. Thorac. Cardiovasc. Surg., September 1, 1995; 110(3): 663 - 671. [Abstract] [Full Text]

				H. Pouleur and M. Buyse EFFECTS OF DIPYRIDAMOLE IN COMBINATION WITH ANTICOAGULANT THERAPY ON SURVIVAL AND THROMBOEMBOLIC EVENTS IN PATIENTS WITH PROSTHETIC HEART VALVESA meta-analysis of the randomized trials J. Thorac. Cardiovasc. Surg., August 1, 1995; 110(2): 463 - 472. [Abstract] [Full Text]

				R. P. Cochran, K. S. Kunzelman, A. C. Eddy, B. O. Hofer, and E. D. Verrier Modified conduit preparation creates a pseudosinus in an aortic valve-sparing procedure for aneurysm of the ascending aorta J. Thorac. Cardiovasc. Surg., June 1, 1995; 109(6): 1049 - 1058. [Abstract] [Full Text]

				S. Khan, A. Chaux, J. Matloff, C. Blanche, M. DeRobertis, R. Kass, T. P. Tsai, A. Trento, S. Nessim, R. Gray, et al. The St. Jude Medical valveExperience with 1000 cases J. Thorac. Cardiovasc. Surg., December 1, 1994; 108(6): 1010 - 1020. [Abstract] [Full Text]

				S. Aoyagi, A. Oryoji, Y. Nishi, K. Tanaka, K. Kosuga, and K. Oishi Long-term results of valve replacement with the St. Jude Medical valve J. Thorac. Cardiovasc. Surg., December 1, 1994; 108(6): 1021 - 1029. [Abstract] [Full Text]

				K. Nakano, H. Koyanagi, A. Hashimoto, G. Ohtsuka, and C. Nojiri Tricuspid valve replacement with the bileaflet St. Jude Medical valve prosthesis J. Thorac. Cardiovasc. Surg., November 1, 1994; 108(5): 888 - 892. [Abstract] [Full Text]

				M. Ibrahim, H. O'Kane, J. Cleland, D. Gladstone, M. Sarsam, and C. Patterson The St. Jude Medical prosthesisA thirteen-year experience J. Thorac. Cardiovasc. Surg., August 1, 1994; 108(2): 221 - 230. [Abstract] [Full Text]

				J. Fernandez, G. W. Laub, M. S. Adkins, W. A. Anderson, C. Chen, B. M. Bailey, L. M. Nealon, and L. B. McGrath Early and late-phase events after valve replacement with the St. Jude Medical prosthesis in 1200 patients J. Thorac. Cardiovasc. Surg., February 1, 1994; 107(2): 394 - 407. [Abstract] [Full Text]

				M. H. Eckman, H. J. Levine, and S. G. Pauker Effect of Laboratory Variation in the Prothrombin-Time Ratio on the Results of Oral Anticoagulant Therapy N. Engl. J. Med., September 2, 1993; 329(10): 696 - 702. [Abstract] [Full Text]

				K.V. Hall The Medtronic-Hall valve: a design in 1977 to improve the results of valve replacement Eur. J. Cardiothorac. Surg., January 1, 1992; 6(suppl_1): S64 - S67. [Abstract] [PDF]