Performance of the Smeloff aortic valve beyond ten years.
The Smeloff aortic valve has remained unchanged in design and material since 1966. To assess the long-term performance of this prosthesis, we reviewed 394 consecutive patients undergoing elective aortic valve replacement. Concomitant coronary artery bypass grafting was performed in 26.4% of these patients. Follow-up was complete in 96%; maximum follow-up was 13.1 years (mean 4.3 years). The operative mortality was 7.4%. Actuarial survival rate, including operative mortality, was 66.3% +/- 2.8% at 5 years and 48.7% +/- 4.5% at 10 years. Thromboembolism for the entire group occurred at a rate of 3.8% per patient-year. Patients who underwent anticoagulation continuously had a rate of embolision of 1.8% per patient-year. All patients had a 5 year embolus-free rate of 91% +/- 2% and a 10 year embolus-free rate of 85% +/- 3%. Patients receiving anticoagulants had a 5 year embolus-free rate of 92% +/- 2% and a 10 year embolus-free rate of 89% +/- 3%. There was no mechanical failure or prosthetic thrombosis in 1,690 patient-years of follow-up. The Smeloff aortic valve has excellent long-term durability and thromboembolism is low in patients receiving anticoagulants.
D000206:Actuarial Analysis; D000293:Adolescent; D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D001021:Aortic Valve; D001026:Coronary Artery Bypass; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011474:Prosthesis Design; D013923:Thromboembolism / Q000209:etiology; D013997:Time Factors
D000925:Anticoagulants