MIDTERM FOLLOW-UP AFTER HEART-VALVE REPLACEMENT WITH CARBOMEDICS BILEAFLET PROSTHESES

The CarboMedics cardiac prosthesis (CarboMedics, Inc., Austin, Tex.) i s a relatively new, low-profile bileaflet prosthesis. We report the re sults of a prospective mid-term evaluation of 426 CarboMedics prosthes es implanted at our institution. Three hundred fifty patients had Carb oMedics prostheses implanted in the mitral (n = 125), aortic (n = 149) , or aortic and mitral positions (n = 76). Hospital mortality was 5.2 %. Follow-up was 98% complete, with 478 patient/years and a mean follo w-up of 19 months (range 1 to 42 months). Actuarial freedom from compl ications were calculated as follows (linearized rates in parentheses): late mortality 97 % +/- 0.77 % (2.7 %), thromboembolism 98 % +/- 0.4 % (0.5 %), anticoagulation-related hemorrhage 98.6 % +/- 0.4 % (0.4 %) , nonstructural dysfunction 98.5 % +/- 0.6 (0.2 %), valve-related mort ality 91.5 % +/- 0.7 (0.5 % ), valve failure 90.9 % +/- 1 % (0.7 %), t reatment failure 92.8 % +/- 0.8 % (0.7 %), and all valve-related morbi dity and mortality 90 % +/- 2 % (2.6 %). According to our results, the CarboMedics valve has a low rate of complications that further improv es the quality of life in patients with heart valve prostheses.