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Ann Thorac Surg 2005;79:1939-1944
© 2005 The Society of Thoracic Surgeons

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Original article: Cardiovascular

Long-Term Result of 1144 CarboMedics Mechanical Valve Implantations

Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea

Accepted for publication December 21, 2004.

^_* Address reprint requests to Dr Ahn, Department of Thoracic & Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-Dong, Chongro-Gu, Seoul 110-744, Korea (E-mail: ahnhyuk{at}snu.ac.kr).

BACKGROUND: It has been reported that the CarboMedics mechanical valve has acceptable valve-related complication rates. The aim of this study was to evaluate the long-term performance of the CarboMedics valve.

METHODS: Between August 1988 and September 1999, we implanted 1144 CarboMedics valves in 850 patients (aortic, 179; mitral, 385; double-valve, 234; tricuspid, 52). Mean patient age was 44.5 ± 12.5 years. Follow-up was completed in 95.3% and the median follow-up period was 7.9 years (6753 patient-years). Patients were divided into four groups according to implanted valve location and number (aortic, mitral, double, and tricuspid valve groups).

RESULTS: The overall hospital mortality rate was 3.4%, and the mortality rates in these groups were 1.7% in the aortic, 2.6% in the mitral, 4.7% in the double, and 9.6% in the tricuspid valve. The tricuspid valve group revealed a significantly higher mortality rate than the aortic and mitral valve groups (p < 0.05). Overall 10-year survival was 87.1% ± 2.6%, 88.9% ± 1.7%, 82.4% ± 2.9%, and 77.5% ± 7.0% in the aortic, mitral, double, and tricuspid valve groups, respectively. Age and tricuspid valve replacement were identified as significant risk factors of long-term survival by multivariate analysis (p < 0.05), and 99.4% ± 0.6%, 98.2% ± 0.8%, 99.2% ± 0.8%, and 87.6% ± 0.5% in the aortic, mitral, double, and tricuspid valve groups were free of valve thrombosis at 10 years. The tricuspid valve group demonstrated a significantly higher rate of valve thrombosis (p < 0.05).

CONCLUSIONS: This long-term study of patients that received CarboMedics valve implantation demonstrates that the CarboMedics prosthetic valve has an acceptable incidence of valve-related complications. However, it should be noted that tricuspid valve replacement indicated a higher level of overall mortality and valve thrombosis.

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