Long-term result of 1144 CarboMedics mechanical valve implantations

Abstract

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.