Isolated mitral and aortic valve replacement with the St. Jude Medical valve: a midterm follow-up.
BACKGROUND
In our country, the biological valvular prostheses predominate, considering the difficulties related to anticoagulation, even in young patients, in spite of the need for repeated operations due to the degeneration of the bioprostheses.


OBJECTIVE
To report our consecutive series of recipients of isolated St Jude Medical mechanical valve prosthesis in the mitral (MVR) or aortic (AVR) position.


METHODS
Data from patients operated between January 1995 and December 2003 were revised in order to determine patient survival and prosthesis-related events up to December 2006.


RESULTS
One hundred sixty eight patients had MVR and 117 had AVR. In the MVR cohort, the mean age was 45 years, 75% were 55 years old or younger, and 65% were females. In the ARV cohort, the mean age was 45 years, 66% were 55 years old or younger and 69% were males. Operative mortality for AVR and MVR was 7% and 7.5%, respectively. Freedom from late mortality was 81.8% at 10 years for MVR and 83% for AVR (p=0.752). Freedom from valve-related death at 10 years for the MVR cohort and AVR was 85.6% and 88.7%, respectively (p=0.698). In the MVR cohort, the freedom from reoperation was 97% and 99% in the AVR cohort (p=0.335). Freedom from thromboembolic events was 82% in the MVR cohort and 98% in the AVR cohort (p=0.049). Freedom from bleeding was 71% in the MVR cohort and 86% n the AVR cohort (0.579). Freedom from endocarditis was 98% in the MVR cohort and 99% in the AVR cohort (p=0.534).


CONCLUSIONS
This series of predominantly young adult patients undergoing isolated MVR and AVR with the St Jude Medical mechanical prosthesis confirms the good performance of this valve prosthesis in agreement with previous reports.
Departamento de Cirurgia e Anatomia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Av. Bandeirantes 3.900, São Paulo, SP, Brazil.
Alfredo José
AJ
Rodrigues
Paulo Roberto Barbosa
PR
Evora
Solange
S
Bassetto
Lafaiete
L
Alves
Adilson
A
Scorzoni Filho
Walter Villela A
WV
Vicente
D000293:Adolescent; D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D002648:Child; D004696:Endocarditis / Q000209:etiology / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000401:mortality; D011474:Prosthesis Design; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000401:mortality; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D055815:Young Adult