title: Twenty-five year experience with the St. Jude medical mechanical valve prosthesis.
abstract: BACKGROUND
  We evaluated all adult St. Jude mechanical valve recipients at our institution since the initial implant in January 1979 and now present our 25-year experience.
  
  
  METHODS
  Nine hundred forty-five valve recipients were followed prospectively at 12-month intervals from January 1979 to December 2007.
  
  
  RESULTS
  Operative mortality was 3% in the aortic valve recipients and 5% in the mitral valve recipients. Follow-up was 95% complete. Among aortic valve recipients, late actuarial survival was 81% +/- 2%, 59% +/- 2%, 41% +/- 3%, 28% +/- 3%, and 17% +/- 4% at 5, 10, 15, 20, and 25 years, respectively. Twenty-five-year freedom from reoperation, thromboembolism, bleeding, and endocarditis was 90% +/- 2%, 69% +/- 5%, 67% +/- 3%, and 9% 3 +/- 2% respectively. Among mitral valve recipients late actuarial survival was 84% +/- 2%, 63% +/- 3%, 44% +/- 3%, 31% +/- 3%, and 23% +/- 4% at 5, 10, 15, 20, and 25 years, respectively. Twenty-five-year freedom from reoperation, thromboembolism, bleeding and endocarditis was 81% +/- 10%, 52% +/- 8%, 64% +/- 6%, and 97% +/- 1%. Freedom from valve-related mortality and morbidity at 25 years was 26% +/- 7% and 29% +/- 6% for aortic and mitral valve replacement, respectively. Freedom from valve-related mortality was 66% +/- 8% and 87% +/- 3% for aortic and mitral valve replacement, respectively.
  
  
  CONCLUSIONS
  These results compare favorably with those for other mechanical prostheses. After two and a half decades of observation with close follow-up, the St. Jude mechanical valve continues to be a reliable prosthesis.
authors.affiliation: Division of Cardiothoracic Surgery, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
authors.forename: J Matthew
authors.initials: JM
authors.lastname: Toole
authors.forename: Martha R
authors.initials: MR
authors.lastname: Stroud
authors.forename: John M
authors.initials: JM
authors.lastname: Kratz
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: Crumbley
authors.forename: Scott M
authors.initials: SM
authors.lastname: Bradley
authors.forename: Fred A
authors.initials: FA
authors.lastname: Crawford
authors.forename: John S
authors.initials: JS
authors.lastname: Ikonomidis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001705:Bioprosthesis; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000601:surgery; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods* / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D015999:Multivariate Analysis; D016017:Odds Ratio; D011183:Postoperative Complications / Q000401:mortality; D011336:Probability; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011474:Prosthesis Design; D011475:Prosthesis Failure; D018570:Risk Assessment; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult