ST-JUDE VERSUS CARBOMEDICS(R) - FOLLOW-UP AFTER PROSTHETIC VALVE-REPLACEMENT

Background. The purpose of the present study was to evaluate the immed iate and long-term outcome of patients with two types of mechanical bi leaflet heart valves operated on in the same institution by the same g roup of surgeons. Methods. A comparative analysis was made in 229 cons ecutive patients receiving either the St. Jude Medical (SJM) or CarboM edics (CMS) bileaflet mechanical valve in 1990-1991. There were no dif ferences in the preoperative demographics between the two groups. At o perations simultaneous coronary bypass operation was performed in 40 p atients out of 134 (30%) in the SJM group and 95 (44%) in the CMS grou p (p=0.026). Sixteen patients in the SJM group underwent replacement o f the ascending aorta with a composite graft and none in the CMS group . Results. There was no difference in hospital mortality between the S JM (6.7%) and CMS (6.3%) groups or in other immediate postoperative co mplications. The patients were followed up to 32 months. There were mo re patients in the NYHA class I and II in the CMS group (88%) than in the SJM group (69%), p<0.002. Three were II thromboembolic events (0.0 51% per patient year) in the SJM group and one thromboembolic event (0 .008% per patient year) in the CMS group. There were no other differen ces between the groups in long-term survival, rate of bleeding, infect ive endocarditis or perivalvular leakage. Conclusions. With the except ion of a Little more favourable exercise tolerance and fewer thromboem bolic events in the CMS group there were no other differences in the o utcome of patients with these two types of bileaflet mechanical valves .