Twenty-Five Year Experience With the St. Jude Medical Mechanical Valve Prosthesis

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.