Technical aspects of valvular replacement with the St. Jude prosthesis.

Abstract Technical aspects for the implantation of the St. Jude Medical prosthesis are discussed. In our experience with 588 implants, the most important considerations are removal of residual calcium and preparation of annular and subvalvular areas, correct assessment of annular size, selection of proper prosthetic size, and placement of the sutures avoiding the use of pledgets on the ventricular side of the prosthesis. A special valve orientation is not needed in the great majority of patients, but necessary guidelines for individual patients were discussed. Using these technical guidelines, implantation of this prosthesis is simple, results in a low incidence of complications, and avoids damage to the prosthesis during implantation.