Twenty-year comparison of tissue and mechanical valve replacement

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Presentation transcript:

Twenty-year comparison of tissue and mechanical valve replacement Steven S. Khan, MD, FACCa, Alfredo Trento, MDb, Michele DeRobertis, RNb, Robert M. Kass, MDb, Meenu Sandhu, MSc, Lawrence S.C. Czer, MDa, Carlos Blanche, MDb, Sharo Raissi, MDb, Gregory P. Fontana, MDb, Wen Cheng, MDb, Aurelio Chaux, MDc, Jack M. Matloff, MD* The Journal of Thoracic and Cardiovascular Surgery Volume 122, Issue 2, Pages 257-269 (August 2001) DOI: 10.1067/mtc.2001.115238 Copyright © 2001 American Association for Thoracic Surgery Terms and Conditions

Fig. 1 Freedom from embolism for tissue and St Jude Medical valves. A, Aortic valve embolism data; B, mitral valve embolism data. The P value compares tissue and mechanical valve embolism rates. The numbers below the figure are the numbers of patients at risk at the beginning of each time period. NS , Not significant. The Journal of Thoracic and Cardiovascular Surgery 2001 122, 257-269DOI: (10.1067/mtc.2001.115238) Copyright © 2001 American Association for Thoracic Surgery Terms and Conditions

Fig. 2 Freedom from hemorrhage comparing tissue and St Jude Medical valves stratified by valve position. A, Aortic hemorrhage rates; B, mitral hemorrhage rates. NS , Not significant. The Journal of Thoracic and Cardiovascular Surgery 2001 122, 257-269DOI: (10.1067/mtc.2001.115238) Copyright © 2001 American Association for Thoracic Surgery Terms and Conditions

Fig. 3 Actuarial and actual freedom from reoperation for tissue and mechanical valves categorized by age. The P values refer to the comparison of the actuarial tissue and mechanical data. A, Aortic tissue valve recipients; B, mitral tissue valve recipients. The Journal of Thoracic and Cardiovascular Surgery 2001 122, 257-269DOI: (10.1067/mtc.2001.115238) Copyright © 2001 American Association for Thoracic Surgery Terms and Conditions

Fig. 4 Annual risk (hazard) of undergoing valve reoperation. A, Aortic tissue valve recipients; B, mitral tissue valve recipients. The Journal of Thoracic and Cardiovascular Surgery 2001 122, 257-269DOI: (10.1067/mtc.2001.115238) Copyright © 2001 American Association for Thoracic Surgery Terms and Conditions

Fig. 5 Survival stratified by patient age. A, Aortic tissue and St Jude Medical valve recipients; B, mitral tissue and St Jude Medical valve recipients. NS , Not significant. The Journal of Thoracic and Cardiovascular Surgery 2001 122, 257-269DOI: (10.1067/mtc.2001.115238) Copyright © 2001 American Association for Thoracic Surgery Terms and Conditions

Fig. 6 Freedom from all valve complications, including valve thrombosis, embolism, hemorrhage, perivalvular leak, structural failure, endocarditis, pannus formation, annular erosion, reoperation, valve-related death, death within 30 days of reoperation, valve failure, and hemolysis. A, Aortic valve recipients; B, mitral valve recipients. Two statistical tests are shown; the Wilcoxon-Breslow test gives greater weight to early events, and the Mantel-Cox test weights early and late events equally. NS , Not significant. The Journal of Thoracic and Cardiovascular Surgery 2001 122, 257-269DOI: (10.1067/mtc.2001.115238) Copyright © 2001 American Association for Thoracic Surgery Terms and Conditions