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THE JOURNAL OF CARDIOVASCULAR SURGERY

A Journal on Cardiac, Vascular and Thoracic Surgery


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ORIGINAL ARTICLE  CARDIAC SECTION


The Journal of Cardiovascular Surgery 2018 April;59(2):252-8

DOI: 10.23736/S0021-9509.17.10044-3

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

On-X versus St Jude Medical Mechanical Prosthesis in mitral position: are we moving forward in design technology?

Ezzeldin A. MOSTAFA 1, Ashraf A. EL MIDANY 1 , Ahmed S. TAHA 1, Saeed R. EL-AASY 1, Ayman A. DOGHISH 1, Ahmed HELMY 1, Sherif A. MANSOUR 1, Ramy KHORSHID 1, Hosam E. ASHOR 1, Yaser ELNAHAS 1, Mohammed SAFFAN 2

1 Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine, Ain-Shams University Hospital, Cairo, Egypt; 2 Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine, Banha University, Banha, Egypt


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BACKGROUND: Continuous effort is still provided in designing optimal artificial heart valves with better hemodynamic function and reduced thromboembolic potential. The question is do we have moved forward toward this goal or not.
METHODS: A prospective, randomized comparative study was done on 360 patients scheduled for elective mitral valve replacement. Patients were grouped into an On-X group (N.=180), who received On-X mechanical valve, and a SJM group (N.=180), who received St Jude mechanical valve. Echocardiographic and clinical assessments were performed for all patients at 6 and 12 months follow-up period.
RESULTS: Rheumatic heart disease was the most common cause of valve affection (94.2%). Early mortality was 6.4%. The mean follow-up time was 3.11±2.44 years. No structural or non-structural valvular dysfunction and no thromboembolism cases were encountered. Late valve thrombosis was1.9%/patient-year in On-X group and 2.1%/patient-year in SJM group. The mean EOA was higher in On-X group (2.0±0.3 cm2) than in SJM group (1.9±0.2 cm2), (P≥0.05). The mean EOAI was higher in On-X group (1.1±0.1 cm2/m2) than in SJM group (1.0±0.1 cm2/m2), (P=0.034), especially significant in small valve size (25 mm) where it was 1.09±021 cm2/m2 in On-X group and 0.93±0.12 cm2/m2 in SJM group (P=0.02).
CONCLUSIONS: On-X and St Jude prosthetic valves have a comparable hemodynamic performance in mitral position. However, On-X prosthesis might have a forward step on the way of design technology that may allow better function in terms of EOA and EOAI especially in smaller valve size.


KEY WORDS: Heart valve prosthesis - Blood vessel prosthesis - Mitral valve annuloplasty

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Publication History

Issue published online: March 23, 2018
Article first published online: July 28, 2017
Manuscript accepted: July 27, 2017
Manuscript received: May 22, 2017

Cite this article as

Mostafa EA, El Midany AA, Taha AS, El-Aasy SR, Doghish AA, Helmy A, et al. On-X versus St Jude Medical Mechanical Prosthesis in mitral position: are we moving forward in design technology? J Cardiovasc Surg 2018;59:252-8. DOI: 10.23736/S0021-9509.17.10044-3

Corresponding author e-mail

ashelmidany@gmail.com