Sudden death in a large prosthetic valve series based on a single prosthesis: experience with the medtronic Hall valve.
In order to test the validity of the current guidelines on the categorization of non-autopsied sudden death after valve replacement, a detailed analysis was undertaken of 412 deaths in a large single-institution prosthetic series based on one type of prosthesis (Medtronic Hall) over a 13-year period. Of 69 sudden or unwitnessed deaths, 48 (70%) were autopsied. There were no sudden deaths specifically related to the prosthesis itself, 79% of deaths were due to coronary disease or left ventricular dysfunction and 10% were due to intracranial hemorrhage. Overall, 90% of sudden deaths were unrelated to the prosthesis A seasonal fluctuation in the incidence of sudden and unwitnessed deaths was demonstrated in keeping with the known epidemiology of sudden death in the general population. It was concluded that there was no evidence to support the recommendation that all non-autopsied sudden deaths should be attributed to the prosthesis.
Rooney
S J
SJ
Department of Cardiac Surgery, University Hospital of Wales, Cardiff, UK.
Moreno de la Santa
P
P
Lewis
P A
PA
Butchart
E G
EG
D002543:Cerebral Hemorrhage / Q000150:complications; D003327:Coronary Disease / Q000150:complications; D003645:Death, Sudden / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D006350:Heart Valve Prosthesis / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D006801:Humans; D015994:Incidence; D015203:Reproducibility of Results