Comparative Evaluation of Mortality and Hemodynamic Performance Between ATS and ST JUDE Mechanical Heart Valves in Mitral and Aortic Positions

Background: Rheumatic heart disease is the most common heart disease in Asian countries especially in Afghanistan, the age adjusted death rate for this heart disease is 27,57 per 100 000 people as published by data of the World Health Organization (WHO). ST JUDE mechanical heart valve first time implanted in October 1977 and quickly became the gold standard for subsequent valves, and ATS medical international developed a mechanical heart valve that has been in use since 1992, these mechanical heart valves started implantation in Afghanistan during 2012. We presented a result of 148 patients who have undergone valve replacement in mitral and aortic position with ATS and ST JUDE mechanical heart valves at departments of cardiothoracic and vascular surgery amiri medical complex and global medical complex heart institute Kabul Afghanistan. Method and results: we performed ATS and ST JUDE mechanical heart valve replacement in 148 patients between May 2015 and April 2018 at both the Department of Cardiothoracic and Vascular Surgery Global Medical Complex heart institute and Amiri Medical Complex, Kabul Afghanistan. Male patients were 69 (46.6%) and female patients were 79 (53.3%), age range was between 11-65 years, 94 (63.5%) patients under went mitral valve replacement, for 38 (25.6%) patients performed aortic valve replacement and 16 (10.8%) patients required double valve replacement, overall mortality was 16 (10.8%) patients for mitral, aortic and double valve replacement. The early mortality (hospital mortality) was 4.05% and late mortality during a 3 year follow up was 6.7%. Conclusion: there were seen a few prosthetic valve complications after ATS and ST JUDE mechanical heart valve implantation (total number of implanted ATS mechanical heart valve were 70 and total number of implanted ST JUDE mechanical heart valve were 78), early mortality was (hospital mortality) 6 patients (4.05%) and late mortality during a 3 year follow up was 10 patients (6.7%). The international normalized ratio (INR) was maintained between (2.5-3.5) in both ATS and ST JUDE mechanical heart valves for mitral position and (2-3) for aortic position, hemodynamically ATS and ST JUDE mechanical heart valves are very good regarding trans valvular gradient and function but low prosthetic valve noise is just seen in ATS mechanical heart valve.