Heart valve replacement with the Björk-Shiley and St Jude Medical prostheses: a randomized comparison in 178 patients.
In 178 patients, a randomized prospective comparison between the 60 degrees spherical disc Björk-Shiley (BS) and the St Jude Medical (SJM) heart valve prostheses was performed. Four-week perioperative mortality was zero in the BS (n = 84) and 4.3% in the SJM group (n = 94). During a mean (+/- SD) follow-up of 52 +/- 20 months or 778 patient-years, late cardiac mortality per year was 2.4% in the BS and 2.2% in the SJM group. The yearly thromboembolic rates were 1.4% in the BS and 2.0% in the SJM group. There was no mechanical valve failure or haemolytic anaemia. Paravalvular leaks and major bleeding complications occurred at low rates in both groups (1.1% and 2.2% per year in BS; 0.7% and 1.7% per year in SJM). Functional results were similarly good with 96% of patients with BS valves and 95% of patients with SJM prostheses being in NYHA classes I and II, respectively. We conclude that heart valve replacement with mechanical prostheses can be performed with equally good results using either the Björk-Shiley spherical disc valve or the St Jude Medical bileaflet prosthesis.
Department of Internal Medicine, University Hospital Basel, Switzerland.
S
S
Vogt
A
A
Hoffmann
J
J
Roth
P
P
Dubach
W
W
Bertschmann
J
J
Hasse
E
E
Grädel
P
P
Stulz
D
D
Burckhardt
D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects; D004562:Electrocardiography; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis / Q000009:adverse effects / Q000401:mortality; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011475:Prosthesis Failure; D016032:Randomized Controlled Trials as Topic; D012086:Reoperation; D015996:Survival Rate; D013923:Thromboembolism / Q000453:epidemiology / Q000209:etiology; D014463:Ultrasonography
D000925:Anticoagulants