Comparison of survival after mitral valve replacement with biologic and mechanical valves in 1139 patients.
OBJECTIVE
We sought to compare 10-year survival in patients after mitral valve replacement with biologic or mechanical valve prostheses.


METHODS
Retrospective survival analysis was performed on data from 1139 consecutive patients older than 18 years of age undergoing mitral valve replacement with Carpentier-Edwards (n = 495; Baxter Healthcare Corp, Irvine, Calif) or St Jude Medical (n = 644; St Jude Medical, Inc, St Paul, Minn) prostheses.


RESULTS
The 10-year survival was not statistically different between the patients receiving Carpentier-Edwards valves and those receiving St Jude Medical valves (P =.16). Adjusted survival estimates at 2, 5, and 10 years were 82% +/- 2% (95% confidence intervals, 79%-85%), 69% +/- 2% (95% confidence intervals, 64%-73%), and 42% +/- 3% (95% confidence intervals, 37%-48%), respectively, for the Carpentier-Edwards group and 83% +/- 2% (95% confidence intervals, 80%-86%), 72% +/- 2% (95% confidence intervals, 69%-76%), and 51% +/- 3% (95% confidence intervals, 45%-58%), respectively, for the St Jude Medical group. Predictors of worse survival after mitral valve replacement are older age, lower ejection fraction, presence of class IV congestive heart failure, coronary artery disease, renal disease, smoking history, hypertension, concurrent other valve surgery, and redo heart surgery.


CONCLUSIONS
Choice of biologic or mechanical prosthesis does not significantly affect long-term patient survival after mitral valve replacement.
Cen
Y Y
YY
Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.
Glower
D D
DD
Landolfo
K
K
Lowe
J E
JE
Davis
R D
RD
Wolfe
W G
WG
Pieper
C
C
Peterson
B
B
D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D001705:Bioprosthesis / Q000592:standards*; D015897:Comorbidity; D005260:Female; D006333:Heart Failure / Q000150:complications; D006350:Heart Valve Prosthesis / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000401:mortality* / Q000601:surgery*; D008945:Mitral Valve Prolapse / Q000150:complications / Q000401:mortality* / Q000601:surgery*; D018579:Patient Selection; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013318:Stroke Volume; D016019:Survival Analysis; D016896:Treatment Outcome