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John S. Ikonomidis - One of the best experts on this subject based on the ideXlab platform.

  • Thirty-year experience with a bileaflet Mechanical Valve prosthesis.
    The Journal of thoracic and cardiovascular surgery, 2018
    Co-Authors: Scott D. Johnson, Scott M. Bradley, Fred A. Crawford, Martha R. Stroud, John M. Kratz, John S. Ikonomidis
    Abstract:

    Abstract Background The objective was to evaluate the long-term outcomes of the St Jude Medical (Saint Paul, Minn) Mechanical Valve prosthesis implantation. Methods Since 1979, every patient receiving this prosthesis has been followed annually. Results From January 1979 to December 2014, 1023 patients were accrued. Patients' ages ranged from 18 to 85 years. Aortic Valve replacement was performed in 584 patients, and mitral Valve replacement was performed in 439 patients. Follow-up was 95% complete. Operative mortality was 3% (17/584, aortic Valve replacement) and 4% (18/439, mitral Valve replacement). In patients undergoing aortic Valve replacement, late actuarial survival was 62% ± 2%, 32% ± 2%, and 14% ± 3% at 10, 20, and 30 years, respectively. Thirty-year freedom from reoperation, thromboembolism, Valve thrombosis, bleeding, and endocarditis was 92% ± 2%, 79% ± 3%, 96% ± 1%, 56% ± 5%, and 92% ± 2%, respectively. In patients undergoing mitral Valve replacement, late actuarial survival was 64% ± 3%, 28% ± 3%, and 14% ± 3% at 10, 20, and 30 years, respectively. Thirty-year freedom from reoperation, thromboembolism, Valve thrombosis, bleeding, and endocarditis was 85% ± 5%, 55% ± 6%, 99% ± 1%, 57% ± 6%, and 95% ± 2%, respectively. The incidence of bleeding was 2.5% and 2.0% per patient-year for aortic Valve replacement and mitral Valve replacement, respectively. The incidence of thromboembolism was 1.6% and 2.9% per patient-year for aortic Valve replacement and mitral Valve replacement, respectively. Conclusions Annual follow-up of all of our patients receiving a St Jude Medical Mechanical Valves prosthesis has allowed better identification Valve-related issues and events. After 3 decades of observation with close follow-up, the St Jude Medical Mechanical Valve continues to be a reliable prosthesis.

  • twenty five year experience with the st jude medical Mechanical Valve prosthesis
    The Annals of Thoracic Surgery, 2010
    Co-Authors: Matthew J Toole, Scott M. Bradley, Fred A. Crawford, Martha R. Stroud, John M. Kratz, Arthur J Crumbley, John S. Ikonomidis
    Abstract:

    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.

  • twenty year experience with the st jude medical Mechanical Valve prosthesis
    The Journal of Thoracic and Cardiovascular Surgery, 2003
    Co-Authors: John S. Ikonomidis, Scott M. Bradley, Robert M. Sade, Martha R. Stroud, John M. Kratz, Arthur J Crumbley, Fred A. Crawford
    Abstract:

    Abstract Background We have prospectively followed all adult St Jude Medical Mechanical Valve recipients at the Medical University of South Carolina since the initial implant in January 1979 and now present our 20-year experience. Methods We prospectively followed 837 Valve recipients (aortic Valve replacement; n = 478; mitral Valve replacement; n = 359) from January 1979 to December 2000 at 12-month intervals. Results Ages ranged from 19 to 84 years. Follow-up averaged (mean ± standard deviation) 7 ± 5 years (98% complete). Patients were in New York Heart Association class III or IV in 77% (aortic Valve replacement) and 89% (mitral Valve replacement) preoperatively. A 19-mm Valve was implanted in 15.5% of aortic Valve replacement patients. Coronary bypass was required in 31% of aortic Valve replacements and 20% of mitral Valve replacements. Operative mortality was 17/478 (3.6%) in aortic Valve replacement and 19/359 (5.3%) in mitral Valve replacement, and multivariable predictors were 19-mm Valve size, 3 or more coronary bypass grafts, and New York Heart Association class IV for aortic Valve replacement and New York Heart Association class IV and age for mitral Valve replacement. Actuarial survivorship at 10 and 20 years was 57% ± 3% and 26% ± 5% for aortic Valve replacement and 61% ± 3% and 39% ± 4% for mitral Valve replacement. Multivariable predictors of late death were African-American ethnicity, New York Heart Association class III or IV, coronary bypass, and age for aortic Valve replacement and New York Heart Association class III or IV, coronary bypass, and age for mitral Valve replacement. For aortic Valve replacement, effective orifice area was univariately ( P = .002) but not multivariately ( P = .378) predictive of late death. Structural Valve deterioration was not observed. For aortic Valve replacement, actuarial freedom (at 10 and 20 years) from reoperation was 93% ± 1% and 90% ± 2%; thromboembolism, 82% ± 3% and 68% ± 8%; bleeding events, 77% ± 3% and 66% ± 6%; prosthetic Valve endocarditis, 94% ± 1% and 94% ± 1%; Valve-related mortality, 94% ± 2% and 86% ± 4%; and Valve-related mortality or morbidity, 58% ± 3% and 32% ± 8%. For mitral Valve replacement, actuarial freedom (at 10 and 20 years) from reoperation was 96% ± 1% and 90% ± 3%; thromboembolism, 77% ± 3% and 59% ± 7%; bleeding events, 86% ± 2% and 65% ± 8%; prosthetic Valve endocarditis, 98% ± 1% and 96% ± 2%; Valve-related mortality, 89% ± 0.2% and 74% ± 8%; and Valve-related mortality or morbidity, 63% ± 3% and 29% ± 7%. Conclusions After 2 decades of observation with close follow-up, the St Jude Medical Mechanical Valve continues to be a reliable prosthesis.

Fred A. Crawford - One of the best experts on this subject based on the ideXlab platform.

  • Thirty-year experience with a bileaflet Mechanical Valve prosthesis.
    The Journal of thoracic and cardiovascular surgery, 2018
    Co-Authors: Scott D. Johnson, Scott M. Bradley, Fred A. Crawford, Martha R. Stroud, John M. Kratz, John S. Ikonomidis
    Abstract:

    Abstract Background The objective was to evaluate the long-term outcomes of the St Jude Medical (Saint Paul, Minn) Mechanical Valve prosthesis implantation. Methods Since 1979, every patient receiving this prosthesis has been followed annually. Results From January 1979 to December 2014, 1023 patients were accrued. Patients' ages ranged from 18 to 85 years. Aortic Valve replacement was performed in 584 patients, and mitral Valve replacement was performed in 439 patients. Follow-up was 95% complete. Operative mortality was 3% (17/584, aortic Valve replacement) and 4% (18/439, mitral Valve replacement). In patients undergoing aortic Valve replacement, late actuarial survival was 62% ± 2%, 32% ± 2%, and 14% ± 3% at 10, 20, and 30 years, respectively. Thirty-year freedom from reoperation, thromboembolism, Valve thrombosis, bleeding, and endocarditis was 92% ± 2%, 79% ± 3%, 96% ± 1%, 56% ± 5%, and 92% ± 2%, respectively. In patients undergoing mitral Valve replacement, late actuarial survival was 64% ± 3%, 28% ± 3%, and 14% ± 3% at 10, 20, and 30 years, respectively. Thirty-year freedom from reoperation, thromboembolism, Valve thrombosis, bleeding, and endocarditis was 85% ± 5%, 55% ± 6%, 99% ± 1%, 57% ± 6%, and 95% ± 2%, respectively. The incidence of bleeding was 2.5% and 2.0% per patient-year for aortic Valve replacement and mitral Valve replacement, respectively. The incidence of thromboembolism was 1.6% and 2.9% per patient-year for aortic Valve replacement and mitral Valve replacement, respectively. Conclusions Annual follow-up of all of our patients receiving a St Jude Medical Mechanical Valves prosthesis has allowed better identification Valve-related issues and events. After 3 decades of observation with close follow-up, the St Jude Medical Mechanical Valve continues to be a reliable prosthesis.

  • twenty five year experience with the st jude medical Mechanical Valve prosthesis
    The Annals of Thoracic Surgery, 2010
    Co-Authors: Matthew J Toole, Scott M. Bradley, Fred A. Crawford, Martha R. Stroud, John M. Kratz, Arthur J Crumbley, John S. Ikonomidis
    Abstract:

    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.

  • twenty year experience with the st jude medical Mechanical Valve prosthesis
    The Journal of Thoracic and Cardiovascular Surgery, 2003
    Co-Authors: John S. Ikonomidis, Scott M. Bradley, Robert M. Sade, Martha R. Stroud, John M. Kratz, Arthur J Crumbley, Fred A. Crawford
    Abstract:

    Abstract Background We have prospectively followed all adult St Jude Medical Mechanical Valve recipients at the Medical University of South Carolina since the initial implant in January 1979 and now present our 20-year experience. Methods We prospectively followed 837 Valve recipients (aortic Valve replacement; n = 478; mitral Valve replacement; n = 359) from January 1979 to December 2000 at 12-month intervals. Results Ages ranged from 19 to 84 years. Follow-up averaged (mean ± standard deviation) 7 ± 5 years (98% complete). Patients were in New York Heart Association class III or IV in 77% (aortic Valve replacement) and 89% (mitral Valve replacement) preoperatively. A 19-mm Valve was implanted in 15.5% of aortic Valve replacement patients. Coronary bypass was required in 31% of aortic Valve replacements and 20% of mitral Valve replacements. Operative mortality was 17/478 (3.6%) in aortic Valve replacement and 19/359 (5.3%) in mitral Valve replacement, and multivariable predictors were 19-mm Valve size, 3 or more coronary bypass grafts, and New York Heart Association class IV for aortic Valve replacement and New York Heart Association class IV and age for mitral Valve replacement. Actuarial survivorship at 10 and 20 years was 57% ± 3% and 26% ± 5% for aortic Valve replacement and 61% ± 3% and 39% ± 4% for mitral Valve replacement. Multivariable predictors of late death were African-American ethnicity, New York Heart Association class III or IV, coronary bypass, and age for aortic Valve replacement and New York Heart Association class III or IV, coronary bypass, and age for mitral Valve replacement. For aortic Valve replacement, effective orifice area was univariately ( P = .002) but not multivariately ( P = .378) predictive of late death. Structural Valve deterioration was not observed. For aortic Valve replacement, actuarial freedom (at 10 and 20 years) from reoperation was 93% ± 1% and 90% ± 2%; thromboembolism, 82% ± 3% and 68% ± 8%; bleeding events, 77% ± 3% and 66% ± 6%; prosthetic Valve endocarditis, 94% ± 1% and 94% ± 1%; Valve-related mortality, 94% ± 2% and 86% ± 4%; and Valve-related mortality or morbidity, 58% ± 3% and 32% ± 8%. For mitral Valve replacement, actuarial freedom (at 10 and 20 years) from reoperation was 96% ± 1% and 90% ± 3%; thromboembolism, 77% ± 3% and 59% ± 7%; bleeding events, 86% ± 2% and 65% ± 8%; prosthetic Valve endocarditis, 98% ± 1% and 96% ± 2%; Valve-related mortality, 89% ± 0.2% and 74% ± 8%; and Valve-related mortality or morbidity, 63% ± 3% and 29% ± 7%. Conclusions After 2 decades of observation with close follow-up, the St Jude Medical Mechanical Valve continues to be a reliable prosthesis.

  • Anticoagulation in Children With Mechanical Valve Prostheses
    The Annals of thoracic surgery, 1997
    Co-Authors: Scott M. Bradley, Robert M. Sade, Fred A. Crawford, Martha R. Stroud
    Abstract:

    Abstract Background . Clotting complications in patients with Mechanical Valve prostheses can be prevented with either warfarin sodium (Coumadin; DuPont, Wilmington, DE) or antiplatelet agents. In children, it is not known whether one treatment regimen is more effective or safe than the other. Methods . We prospectively followed up 64 children and young adults (aged 18 years or younger at implantation) with a Mechanical Valve on the left side of the heart, from October 1986 through October 1996. Forty-eight patients were treated with Coumadin and 16 with aspirin and dipyridamole. The two groups were similar in age, sex, Valve location and size, mean length of follow-up, and operative indication. There has been a total follow-up of 272 patient-years on Coumadin and 116 patient-years on aspirin and dipyridamole. Results . There was no difference between the two groups in survival or freedom from thromboembolism. Bleeding occurred more often in the patients taking Coumadin, but this difference was not statistically significant. Analysis of the literature showed thromboembolism and bleeding rates to be similar in the patients receiving Coumadin and those receiving antiplatelet agents. Conclusions . Coumadin and the combination of aspirin plus dipyridamole provided similar protection against complications in this group of children and young adults with left-sided St. Jude (St. Paul, MN) Mechanical Valves. The choice between the two regimens may depend on other factors, such as patient preference and convenience.

Martha R. Stroud - One of the best experts on this subject based on the ideXlab platform.

  • Thirty-year experience with a bileaflet Mechanical Valve prosthesis.
    The Journal of thoracic and cardiovascular surgery, 2018
    Co-Authors: Scott D. Johnson, Scott M. Bradley, Fred A. Crawford, Martha R. Stroud, John M. Kratz, John S. Ikonomidis
    Abstract:

    Abstract Background The objective was to evaluate the long-term outcomes of the St Jude Medical (Saint Paul, Minn) Mechanical Valve prosthesis implantation. Methods Since 1979, every patient receiving this prosthesis has been followed annually. Results From January 1979 to December 2014, 1023 patients were accrued. Patients' ages ranged from 18 to 85 years. Aortic Valve replacement was performed in 584 patients, and mitral Valve replacement was performed in 439 patients. Follow-up was 95% complete. Operative mortality was 3% (17/584, aortic Valve replacement) and 4% (18/439, mitral Valve replacement). In patients undergoing aortic Valve replacement, late actuarial survival was 62% ± 2%, 32% ± 2%, and 14% ± 3% at 10, 20, and 30 years, respectively. Thirty-year freedom from reoperation, thromboembolism, Valve thrombosis, bleeding, and endocarditis was 92% ± 2%, 79% ± 3%, 96% ± 1%, 56% ± 5%, and 92% ± 2%, respectively. In patients undergoing mitral Valve replacement, late actuarial survival was 64% ± 3%, 28% ± 3%, and 14% ± 3% at 10, 20, and 30 years, respectively. Thirty-year freedom from reoperation, thromboembolism, Valve thrombosis, bleeding, and endocarditis was 85% ± 5%, 55% ± 6%, 99% ± 1%, 57% ± 6%, and 95% ± 2%, respectively. The incidence of bleeding was 2.5% and 2.0% per patient-year for aortic Valve replacement and mitral Valve replacement, respectively. The incidence of thromboembolism was 1.6% and 2.9% per patient-year for aortic Valve replacement and mitral Valve replacement, respectively. Conclusions Annual follow-up of all of our patients receiving a St Jude Medical Mechanical Valves prosthesis has allowed better identification Valve-related issues and events. After 3 decades of observation with close follow-up, the St Jude Medical Mechanical Valve continues to be a reliable prosthesis.

  • twenty five year experience with the st jude medical Mechanical Valve prosthesis
    The Annals of Thoracic Surgery, 2010
    Co-Authors: Matthew J Toole, Scott M. Bradley, Fred A. Crawford, Martha R. Stroud, John M. Kratz, Arthur J Crumbley, John S. Ikonomidis
    Abstract:

    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.

  • twenty year experience with the st jude medical Mechanical Valve prosthesis
    The Journal of Thoracic and Cardiovascular Surgery, 2003
    Co-Authors: John S. Ikonomidis, Scott M. Bradley, Robert M. Sade, Martha R. Stroud, John M. Kratz, Arthur J Crumbley, Fred A. Crawford
    Abstract:

    Abstract Background We have prospectively followed all adult St Jude Medical Mechanical Valve recipients at the Medical University of South Carolina since the initial implant in January 1979 and now present our 20-year experience. Methods We prospectively followed 837 Valve recipients (aortic Valve replacement; n = 478; mitral Valve replacement; n = 359) from January 1979 to December 2000 at 12-month intervals. Results Ages ranged from 19 to 84 years. Follow-up averaged (mean ± standard deviation) 7 ± 5 years (98% complete). Patients were in New York Heart Association class III or IV in 77% (aortic Valve replacement) and 89% (mitral Valve replacement) preoperatively. A 19-mm Valve was implanted in 15.5% of aortic Valve replacement patients. Coronary bypass was required in 31% of aortic Valve replacements and 20% of mitral Valve replacements. Operative mortality was 17/478 (3.6%) in aortic Valve replacement and 19/359 (5.3%) in mitral Valve replacement, and multivariable predictors were 19-mm Valve size, 3 or more coronary bypass grafts, and New York Heart Association class IV for aortic Valve replacement and New York Heart Association class IV and age for mitral Valve replacement. Actuarial survivorship at 10 and 20 years was 57% ± 3% and 26% ± 5% for aortic Valve replacement and 61% ± 3% and 39% ± 4% for mitral Valve replacement. Multivariable predictors of late death were African-American ethnicity, New York Heart Association class III or IV, coronary bypass, and age for aortic Valve replacement and New York Heart Association class III or IV, coronary bypass, and age for mitral Valve replacement. For aortic Valve replacement, effective orifice area was univariately ( P = .002) but not multivariately ( P = .378) predictive of late death. Structural Valve deterioration was not observed. For aortic Valve replacement, actuarial freedom (at 10 and 20 years) from reoperation was 93% ± 1% and 90% ± 2%; thromboembolism, 82% ± 3% and 68% ± 8%; bleeding events, 77% ± 3% and 66% ± 6%; prosthetic Valve endocarditis, 94% ± 1% and 94% ± 1%; Valve-related mortality, 94% ± 2% and 86% ± 4%; and Valve-related mortality or morbidity, 58% ± 3% and 32% ± 8%. For mitral Valve replacement, actuarial freedom (at 10 and 20 years) from reoperation was 96% ± 1% and 90% ± 3%; thromboembolism, 77% ± 3% and 59% ± 7%; bleeding events, 86% ± 2% and 65% ± 8%; prosthetic Valve endocarditis, 98% ± 1% and 96% ± 2%; Valve-related mortality, 89% ± 0.2% and 74% ± 8%; and Valve-related mortality or morbidity, 63% ± 3% and 29% ± 7%. Conclusions After 2 decades of observation with close follow-up, the St Jude Medical Mechanical Valve continues to be a reliable prosthesis.

  • Anticoagulation in Children With Mechanical Valve Prostheses
    The Annals of thoracic surgery, 1997
    Co-Authors: Scott M. Bradley, Robert M. Sade, Fred A. Crawford, Martha R. Stroud
    Abstract:

    Abstract Background . Clotting complications in patients with Mechanical Valve prostheses can be prevented with either warfarin sodium (Coumadin; DuPont, Wilmington, DE) or antiplatelet agents. In children, it is not known whether one treatment regimen is more effective or safe than the other. Methods . We prospectively followed up 64 children and young adults (aged 18 years or younger at implantation) with a Mechanical Valve on the left side of the heart, from October 1986 through October 1996. Forty-eight patients were treated with Coumadin and 16 with aspirin and dipyridamole. The two groups were similar in age, sex, Valve location and size, mean length of follow-up, and operative indication. There has been a total follow-up of 272 patient-years on Coumadin and 116 patient-years on aspirin and dipyridamole. Results . There was no difference between the two groups in survival or freedom from thromboembolism. Bleeding occurred more often in the patients taking Coumadin, but this difference was not statistically significant. Analysis of the literature showed thromboembolism and bleeding rates to be similar in the patients receiving Coumadin and those receiving antiplatelet agents. Conclusions . Coumadin and the combination of aspirin plus dipyridamole provided similar protection against complications in this group of children and young adults with left-sided St. Jude (St. Paul, MN) Mechanical Valves. The choice between the two regimens may depend on other factors, such as patient preference and convenience.

Scott M. Bradley - One of the best experts on this subject based on the ideXlab platform.

  • Thirty-year experience with a bileaflet Mechanical Valve prosthesis.
    The Journal of thoracic and cardiovascular surgery, 2018
    Co-Authors: Scott D. Johnson, Scott M. Bradley, Fred A. Crawford, Martha R. Stroud, John M. Kratz, John S. Ikonomidis
    Abstract:

    Abstract Background The objective was to evaluate the long-term outcomes of the St Jude Medical (Saint Paul, Minn) Mechanical Valve prosthesis implantation. Methods Since 1979, every patient receiving this prosthesis has been followed annually. Results From January 1979 to December 2014, 1023 patients were accrued. Patients' ages ranged from 18 to 85 years. Aortic Valve replacement was performed in 584 patients, and mitral Valve replacement was performed in 439 patients. Follow-up was 95% complete. Operative mortality was 3% (17/584, aortic Valve replacement) and 4% (18/439, mitral Valve replacement). In patients undergoing aortic Valve replacement, late actuarial survival was 62% ± 2%, 32% ± 2%, and 14% ± 3% at 10, 20, and 30 years, respectively. Thirty-year freedom from reoperation, thromboembolism, Valve thrombosis, bleeding, and endocarditis was 92% ± 2%, 79% ± 3%, 96% ± 1%, 56% ± 5%, and 92% ± 2%, respectively. In patients undergoing mitral Valve replacement, late actuarial survival was 64% ± 3%, 28% ± 3%, and 14% ± 3% at 10, 20, and 30 years, respectively. Thirty-year freedom from reoperation, thromboembolism, Valve thrombosis, bleeding, and endocarditis was 85% ± 5%, 55% ± 6%, 99% ± 1%, 57% ± 6%, and 95% ± 2%, respectively. The incidence of bleeding was 2.5% and 2.0% per patient-year for aortic Valve replacement and mitral Valve replacement, respectively. The incidence of thromboembolism was 1.6% and 2.9% per patient-year for aortic Valve replacement and mitral Valve replacement, respectively. Conclusions Annual follow-up of all of our patients receiving a St Jude Medical Mechanical Valves prosthesis has allowed better identification Valve-related issues and events. After 3 decades of observation with close follow-up, the St Jude Medical Mechanical Valve continues to be a reliable prosthesis.

  • twenty five year experience with the st jude medical Mechanical Valve prosthesis
    The Annals of Thoracic Surgery, 2010
    Co-Authors: Matthew J Toole, Scott M. Bradley, Fred A. Crawford, Martha R. Stroud, John M. Kratz, Arthur J Crumbley, John S. Ikonomidis
    Abstract:

    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.

  • twenty year experience with the st jude medical Mechanical Valve prosthesis
    The Journal of Thoracic and Cardiovascular Surgery, 2003
    Co-Authors: John S. Ikonomidis, Scott M. Bradley, Robert M. Sade, Martha R. Stroud, John M. Kratz, Arthur J Crumbley, Fred A. Crawford
    Abstract:

    Abstract Background We have prospectively followed all adult St Jude Medical Mechanical Valve recipients at the Medical University of South Carolina since the initial implant in January 1979 and now present our 20-year experience. Methods We prospectively followed 837 Valve recipients (aortic Valve replacement; n = 478; mitral Valve replacement; n = 359) from January 1979 to December 2000 at 12-month intervals. Results Ages ranged from 19 to 84 years. Follow-up averaged (mean ± standard deviation) 7 ± 5 years (98% complete). Patients were in New York Heart Association class III or IV in 77% (aortic Valve replacement) and 89% (mitral Valve replacement) preoperatively. A 19-mm Valve was implanted in 15.5% of aortic Valve replacement patients. Coronary bypass was required in 31% of aortic Valve replacements and 20% of mitral Valve replacements. Operative mortality was 17/478 (3.6%) in aortic Valve replacement and 19/359 (5.3%) in mitral Valve replacement, and multivariable predictors were 19-mm Valve size, 3 or more coronary bypass grafts, and New York Heart Association class IV for aortic Valve replacement and New York Heart Association class IV and age for mitral Valve replacement. Actuarial survivorship at 10 and 20 years was 57% ± 3% and 26% ± 5% for aortic Valve replacement and 61% ± 3% and 39% ± 4% for mitral Valve replacement. Multivariable predictors of late death were African-American ethnicity, New York Heart Association class III or IV, coronary bypass, and age for aortic Valve replacement and New York Heart Association class III or IV, coronary bypass, and age for mitral Valve replacement. For aortic Valve replacement, effective orifice area was univariately ( P = .002) but not multivariately ( P = .378) predictive of late death. Structural Valve deterioration was not observed. For aortic Valve replacement, actuarial freedom (at 10 and 20 years) from reoperation was 93% ± 1% and 90% ± 2%; thromboembolism, 82% ± 3% and 68% ± 8%; bleeding events, 77% ± 3% and 66% ± 6%; prosthetic Valve endocarditis, 94% ± 1% and 94% ± 1%; Valve-related mortality, 94% ± 2% and 86% ± 4%; and Valve-related mortality or morbidity, 58% ± 3% and 32% ± 8%. For mitral Valve replacement, actuarial freedom (at 10 and 20 years) from reoperation was 96% ± 1% and 90% ± 3%; thromboembolism, 77% ± 3% and 59% ± 7%; bleeding events, 86% ± 2% and 65% ± 8%; prosthetic Valve endocarditis, 98% ± 1% and 96% ± 2%; Valve-related mortality, 89% ± 0.2% and 74% ± 8%; and Valve-related mortality or morbidity, 63% ± 3% and 29% ± 7%. Conclusions After 2 decades of observation with close follow-up, the St Jude Medical Mechanical Valve continues to be a reliable prosthesis.

  • Anticoagulation in Children With Mechanical Valve Prostheses
    The Annals of thoracic surgery, 1997
    Co-Authors: Scott M. Bradley, Robert M. Sade, Fred A. Crawford, Martha R. Stroud
    Abstract:

    Abstract Background . Clotting complications in patients with Mechanical Valve prostheses can be prevented with either warfarin sodium (Coumadin; DuPont, Wilmington, DE) or antiplatelet agents. In children, it is not known whether one treatment regimen is more effective or safe than the other. Methods . We prospectively followed up 64 children and young adults (aged 18 years or younger at implantation) with a Mechanical Valve on the left side of the heart, from October 1986 through October 1996. Forty-eight patients were treated with Coumadin and 16 with aspirin and dipyridamole. The two groups were similar in age, sex, Valve location and size, mean length of follow-up, and operative indication. There has been a total follow-up of 272 patient-years on Coumadin and 116 patient-years on aspirin and dipyridamole. Results . There was no difference between the two groups in survival or freedom from thromboembolism. Bleeding occurred more often in the patients taking Coumadin, but this difference was not statistically significant. Analysis of the literature showed thromboembolism and bleeding rates to be similar in the patients receiving Coumadin and those receiving antiplatelet agents. Conclusions . Coumadin and the combination of aspirin plus dipyridamole provided similar protection against complications in this group of children and young adults with left-sided St. Jude (St. Paul, MN) Mechanical Valves. The choice between the two regimens may depend on other factors, such as patient preference and convenience.

John M. Kratz - One of the best experts on this subject based on the ideXlab platform.

  • Thirty-year experience with a bileaflet Mechanical Valve prosthesis.
    The Journal of thoracic and cardiovascular surgery, 2018
    Co-Authors: Scott D. Johnson, Scott M. Bradley, Fred A. Crawford, Martha R. Stroud, John M. Kratz, John S. Ikonomidis
    Abstract:

    Abstract Background The objective was to evaluate the long-term outcomes of the St Jude Medical (Saint Paul, Minn) Mechanical Valve prosthesis implantation. Methods Since 1979, every patient receiving this prosthesis has been followed annually. Results From January 1979 to December 2014, 1023 patients were accrued. Patients' ages ranged from 18 to 85 years. Aortic Valve replacement was performed in 584 patients, and mitral Valve replacement was performed in 439 patients. Follow-up was 95% complete. Operative mortality was 3% (17/584, aortic Valve replacement) and 4% (18/439, mitral Valve replacement). In patients undergoing aortic Valve replacement, late actuarial survival was 62% ± 2%, 32% ± 2%, and 14% ± 3% at 10, 20, and 30 years, respectively. Thirty-year freedom from reoperation, thromboembolism, Valve thrombosis, bleeding, and endocarditis was 92% ± 2%, 79% ± 3%, 96% ± 1%, 56% ± 5%, and 92% ± 2%, respectively. In patients undergoing mitral Valve replacement, late actuarial survival was 64% ± 3%, 28% ± 3%, and 14% ± 3% at 10, 20, and 30 years, respectively. Thirty-year freedom from reoperation, thromboembolism, Valve thrombosis, bleeding, and endocarditis was 85% ± 5%, 55% ± 6%, 99% ± 1%, 57% ± 6%, and 95% ± 2%, respectively. The incidence of bleeding was 2.5% and 2.0% per patient-year for aortic Valve replacement and mitral Valve replacement, respectively. The incidence of thromboembolism was 1.6% and 2.9% per patient-year for aortic Valve replacement and mitral Valve replacement, respectively. Conclusions Annual follow-up of all of our patients receiving a St Jude Medical Mechanical Valves prosthesis has allowed better identification Valve-related issues and events. After 3 decades of observation with close follow-up, the St Jude Medical Mechanical Valve continues to be a reliable prosthesis.

  • twenty five year experience with the st jude medical Mechanical Valve prosthesis
    The Annals of Thoracic Surgery, 2010
    Co-Authors: Matthew J Toole, Scott M. Bradley, Fred A. Crawford, Martha R. Stroud, John M. Kratz, Arthur J Crumbley, John S. Ikonomidis
    Abstract:

    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.

  • twenty year experience with the st jude medical Mechanical Valve prosthesis
    The Journal of Thoracic and Cardiovascular Surgery, 2003
    Co-Authors: John S. Ikonomidis, Scott M. Bradley, Robert M. Sade, Martha R. Stroud, John M. Kratz, Arthur J Crumbley, Fred A. Crawford
    Abstract:

    Abstract Background We have prospectively followed all adult St Jude Medical Mechanical Valve recipients at the Medical University of South Carolina since the initial implant in January 1979 and now present our 20-year experience. Methods We prospectively followed 837 Valve recipients (aortic Valve replacement; n = 478; mitral Valve replacement; n = 359) from January 1979 to December 2000 at 12-month intervals. Results Ages ranged from 19 to 84 years. Follow-up averaged (mean ± standard deviation) 7 ± 5 years (98% complete). Patients were in New York Heart Association class III or IV in 77% (aortic Valve replacement) and 89% (mitral Valve replacement) preoperatively. A 19-mm Valve was implanted in 15.5% of aortic Valve replacement patients. Coronary bypass was required in 31% of aortic Valve replacements and 20% of mitral Valve replacements. Operative mortality was 17/478 (3.6%) in aortic Valve replacement and 19/359 (5.3%) in mitral Valve replacement, and multivariable predictors were 19-mm Valve size, 3 or more coronary bypass grafts, and New York Heart Association class IV for aortic Valve replacement and New York Heart Association class IV and age for mitral Valve replacement. Actuarial survivorship at 10 and 20 years was 57% ± 3% and 26% ± 5% for aortic Valve replacement and 61% ± 3% and 39% ± 4% for mitral Valve replacement. Multivariable predictors of late death were African-American ethnicity, New York Heart Association class III or IV, coronary bypass, and age for aortic Valve replacement and New York Heart Association class III or IV, coronary bypass, and age for mitral Valve replacement. For aortic Valve replacement, effective orifice area was univariately ( P = .002) but not multivariately ( P = .378) predictive of late death. Structural Valve deterioration was not observed. For aortic Valve replacement, actuarial freedom (at 10 and 20 years) from reoperation was 93% ± 1% and 90% ± 2%; thromboembolism, 82% ± 3% and 68% ± 8%; bleeding events, 77% ± 3% and 66% ± 6%; prosthetic Valve endocarditis, 94% ± 1% and 94% ± 1%; Valve-related mortality, 94% ± 2% and 86% ± 4%; and Valve-related mortality or morbidity, 58% ± 3% and 32% ± 8%. For mitral Valve replacement, actuarial freedom (at 10 and 20 years) from reoperation was 96% ± 1% and 90% ± 3%; thromboembolism, 77% ± 3% and 59% ± 7%; bleeding events, 86% ± 2% and 65% ± 8%; prosthetic Valve endocarditis, 98% ± 1% and 96% ± 2%; Valve-related mortality, 89% ± 0.2% and 74% ± 8%; and Valve-related mortality or morbidity, 63% ± 3% and 29% ± 7%. Conclusions After 2 decades of observation with close follow-up, the St Jude Medical Mechanical Valve continues to be a reliable prosthesis.