title: 40 Years experience in mitral valve replacement using Starr-Edwards, St. Jude Medical and ATS valves.
abstract: BACKGROUND
  We have used the Starr-Edwards ball (S-E) valve since 1963, the St. Jude Medical (SJM) valve since 1978, and the ATS valve, since 1993 as the first choice of mechanical valve. In this study, the results with each valve during the 40 years were investigated in single mitral valve replacement (MVR) cases.
  
  
  METHODS
  The mean age for S-E valves was 32.8+/-11.1 years old (y.o.), for SJM it was 47.2+/-12.6 y.o. and for ATS it was 56.3+/-11.4 y.o., indicating the aging of patients over time. The operative mortality decreased over the same time from 10.3% to 5.2% then 1.4% respectively. A significant difference was observed among the 3 groups with regards to the valve-related complication-free rate and cardiac event-free rate. However, there was no significant difference among the 3 groups with the other complications.
  
  
  CONCLUSIONS
  Although there are many cases of valve-related complications with S-E valves, they have a role as an initial stage mechanical valve. In view of the long-term results extending over 20 years, the SJM valves is considered as the most reliable valve. The ATS valve is expected to achieve favorable results in the future because it may improve the quality of life (QOL) of patients and produce fewer valve-related complications.
authors.affiliation: Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Sezai
authors.forename: Motomi
authors.initials: M
authors.lastname: Shiono
authors.forename: Mitsumasa
authors.initials: M
authors.lastname: Hata
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Iida
authors.forename: Masataka
authors.initials: M
authors.lastname: Yoda
authors.forename: Shinji
authors.initials: S
authors.lastname: Wakui
authors.forename: Masao
authors.initials: M
authors.lastname: Soeda
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Umeda
authors.forename: Kazuma
authors.initials: K
authors.lastname: Shimura
authors.forename: Nanao
authors.initials: N
authors.lastname: Negishi
authors.forename: Yukiyasu
authors.initials: Y
authors.lastname: Sezai
authors.forename: Kazutomo
authors.initials: K
authors.lastname: Minami
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000401:mortality / Q000601:surgery*; D006350:Heart Valve Prosthesis / Q000009:adverse effects; D019918:Heart Valve Prosthesis Implantation; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D011474:Prosthesis Design; D011788:Quality of Life; D016019:Survival Analysis; D016896:Treatment Outcome