Replacement of the aortic valve in patients under 50 years of age: long-term follow-up of the St. Jude medical prosthesis
| Autor: | Robert W, Emery, Carla A, Erickson, Kit V, Arom, William F, Northrup, Thomas E, Kersten, Thomas J, Von Rueden, Theodore J, Lillehei, Demetre M, Nicoloff |
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| Rok vydání: | 2003 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine Aortic valve medicine.medical_specialty Adolescent medicine.medical_treatment Aortic Valve Insufficiency Prosthesis Design Prosthesis Postoperative Complications Aortic valve replacement Cause of Death Thromboembolism Product Surveillance Postmarketing medicine Humans Endocarditis International Normalized Ratio Young adult Survival rate Cause of death business.industry Incidence (epidemiology) Anticoagulants Aortic Valve Stenosis Middle Aged medicine.disease Surgery Equipment Failure Analysis Survival Rate medicine.anatomical_structure Aortic Valve Heart Valve Prosthesis Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | The Annals of Thoracic Surgery. 75:1815-1819 |
| ISSN: | 0003-4975 |
| DOI: | 10.1016/s0003-4975(03)00016-x |
| Popis: | Background Aortic valve replacement in the young adult (aged 18 to 50 years) is a choice between a mechanical prosthesis with attendant lifelong anticoagulation or biological prostheses of varying types that may have limited life expectancy in this age group. Methods The Cardiac Surgical Research Foundation database was accessed to determine long-term outcomes in patients having aortic valve replacement with the St. Jude Medical Valve. This database has been privately maintained since the world's first St. Jude Medical (SJM) valve implant in 1977. Patients were contacted by questionnaire or by telephone if the survey was not returned. Follow-up was 93% complete. Results From October 1977 through October 1997, 271 patients less than 50 years of age had isolated aortic valve replacement. Follow-up was 1957 patient years. Thirty-day operative mortality was 1.1% with 18 late deaths, 4 of which were valve related. Ninety percent of survivor INR responses indicated a frequency of monthly INR checks or less. Valve-related events including percent per patient year and mortality related to these events included thromboembolism, 6 episodes (0.3% per patient year, no deaths); anticoagulant-related bleeding, 6 events (0.3% per patient year, 2 deaths); paravalvular leak, 6 events (0.3% per patient year, 2 deaths); valve thrombosis, 2 events (0.1% per patient year, no deaths); and endocarditis, 3 events (0.15% per patient year, no deaths). There was no incidence of structural valve failure. Conclusions The SJM valve has a long record of excellent performance with durability lasting more than 20 years. The incidence of untoward events is low and death over time due to valve-related complications is low (4 of 271). The SJM valve has become our valve of choice for younger patients. |
| Databáze: | OpenAIRE |
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