| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Eur J Cardiothorac Surg 1998;13:151-159
© 1998 Elsevier Science NL
Department of Surgery, St. Paul’s Hospital-Heart Centre, Vancouver General Hospital, University of British Columbia, 3100-910 West 10th Avenue, Vancouver V5Z 4E3, Canada
Received 28 July 1997; received in revised form 8 December 1997; accepted 16 December 1997.
Corresponding author. Tel. +1 604 8754141; fax: +1 604 8754036.
Objective: The experience with the St. Jude Medical (SJM) and CarboMedics (CM) bileaflet mechanical prostheses was evaluated to determine thromboembolic and hemorrhagic complications and predictive risk factors. Methods: From 1989 to 1994, a total of 246 patients had multiple valve replacement (SJM, 140; CM, 106); concomitant procedures 20.3% (50) [coronary artery bypass 10.6% (26)] and 53.7% (132) previous cardiac surgery, primarily valve replacement procedures. The pre-operative variables [coronary artery disease, previous cardiovascular surgery, concomitant procedures, valve lesion (except mitral stenosis), status, atrial fibrillation, and NYHA III/IV] did not distinguish the prosthesis-type (pNS). Results: The prosthesis-type and the pre-operative variables, including atrial fibrillation, were not predictive of overall thromboembolism (TE). The linearized rate of total TE events for overall multiple replacements (MR) was 5.4%/patient-year (minor, 2.52; major 2.85); the total TE for CM and SJM was 5.4%/patient-year, respectively. The 
30 day major TE crude rate was 0.82%, while the >30 day major event rate was 2.7%/patient-year. Of the total (major and minor) TE events 100% (3) of 30 days and 72% (29), >30 days had an INR <2.5 at or immediately prior to the event. The thrombosis rate (included in total TE events) was 0.67%/patient-year (4 events, 100% INR <2.5). Of the various TE event categories the prosthesis-types (CM and SJM) were not differentiated (pNS). The freedom, at 5 years, from major/fatal TE, thrombosis and hemorrhage from anticoagulation was 89.3±3.8% for CM and 87.9±3.7% for SJM and, 91.3±3.5% and 89.3±3.7%, respectively, (pNS) exclusive of early events. Conclusions: The performance of the CarboMedics and St. Jude Medical prostheses in multiple valve replacement surgery in this non-randomized prospective study revealed no significant differences in performance with regard to thromboembolic and hemorrhagic complications.
Key Words: Mechanical prostheses • Thromboembolism • Predictive factors and anticoagulation
This article has been cited by other articles:
|
|
 |
|
  A. J. Bryan, C. A. Rogers, K. Bayliss, J. Wild, and G. D. Angelini Prospective randomized comparison of CarboMedics and St. Jude Medical bileaflet mechanical heart valve prostheses: Ten-year follow-up J. Thorac. Cardiovasc. Surg., March 1, 2007; 133(3): 614 - 622. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Fritzsche, T. Eitz, A. Laczkovics, A. Liebold, M. Knaut, K. Matschke, A. Sagie, U. Mehlhorn, D. Horstkotte, and R. Koerfer Early Detection of Mechanical Valve Dysfunction Using a New Home Monitoring Device Ann. Thorac. Surg., February 1, 2007; 83(2): 542 - 548. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Vesely Heart Valve Tissue Engineering Circ. Res., October 14, 2005; 97(8): 743 - 755. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. H. H. Lim, M. Caputo, R. Ascione, J. Wild, R. West, G. D. Angelini, A. J. Bryan, and S. A. M. Calafiore Prospective randomized comparison of CarboMedics and St Jude Medical bileaflet mechanical heart valve prostheses: An interim report J. Thorac. Cardiovasc. Surg., January 1, 2002; 123(1): 21 - 32. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
