Long-term Results after 1,144 CarboMedics Mechanical Valve Implantation

Kang, Chang Hyun; Kim, Kyung Hwan; Kim, Ki Bong; Ahn, Hyuk

Abstract

BACKGROUND: The CarboMedics mechanical valve has been reported to show acceptable valve-related complication rates. The aim of this study is to evaluate our clinical experience with the CarboMedics valve. MATERIAL AND METHOD: Between August 1988 and September 1999, we implanted 1,144 CarboMedics valves in 850 patients (aortic 179; mitral 385; double-valve 234; tricuspid 52). The mean age was 44.5+/-12.5 years. Follow-up was completed in 95.2% and median follow-up period was 7.9 years (6753 patient-years). RESULT: The overall hospital mortality rate was 3.4% and the mortality rate for each group was 1.7% for aortic group, 2.6% for mitral group, 4.7% for double-valve group, and 9.6% for tricuspid group. Tricuspid group showed significantly higher mortality rate than aortic and mitral group (p<0.05). The actuarial survival at 10 years was 87.1+/-2.6%, 88.9+/-1.7%, 82.4+/-2.9%, and 77.5+/-7.0% for aortic, mitral, double, and tricuspid valve group, respectively. Age and tricuspid valve replacement were significant risk factors for long-term survival in multivariate analysis (p<0.05). Freedom from valve thrombosis at 10 years was 99.4+/-0.6%, 98.2+/-0.8%, 99.2+/-0.8%, and 87.6+/-0.5% for aortic, mitral, double and tricuspid valve group. Tricuspid valve group showed significantly higher rate of valve thrombosis (p<0.05).
CONCLUSION
Long-term results of our experience demonstrated that CarboMedics valve showed acceptable incidence of valve-related complications. However, tricuspid valve replacement showed higher rate of early mortality and valve thrombosis than other valve replacement groups.