Comparison of survival after mitral valve replacement with biologic and mechanical valves in 1139 patients

Objective: We sought to compare 10-year survival in patients after mitral v alve replacement with biologic or mechanical valve prostheses. Methods: Retrospective survival analysis was performed on data from 1139 co nsecutive patients older than 18 years of age undergoing mitral valve repla cement with Carpentier-Edwards (n = 495; Baxter Healthcare Corp, Irvine, Ca lif) or St Jude Medical (n = 644; St Jude Medical, Inc, St Paul, Minn) pros theses. Results: The 10-year survival was not statistically different between the p atients receiving Carpentier-Edwards valves arid those receiving St Jude Me dical valves (P =.16). Adjusted survival estimates at 2, 5, and 10 years we re 82% +/- 2% (95% confidence intervals, 79%-85%), 69% 2% (95% confidence i ntervals, 64%-73%), and 42% +/- 3% (95% confidence intervals, 37%-48%), res pectively, for the Carpentier-Edwards group and 83% +/- 2% (95% confidence intervals, 80%-86%), 72% +/- 2% (95% confidence intervals, 69%-76%), and 51 % +/- 3% (95% confidence intervals, 45%-58%), respectively, for the St Jude Medical group. Predictors of worse survival after mitral valve replacement are older age, lower ejection fraction, presence of class IV congestive he art failure, coronary artery disease, renal disease, smoking history, hyper tension, concurrent other valve surgery, and redo heart surgery. Conclusion: Choice of biologic or mechanical prosthesis does not significan tly affect long-term patient survival after mitral valve replacement.