Isolated mitral valve replacement with St. Jude medical prosthesis: long-term results: a follow-up of 19 years.

BACKGROUND: In this retrospective study, approximately 440 patients received mitral valve replacements with the St Jude Medical prosthesis. The last patient was operated on 10 years before the beginning of the follow-up. The extended follow-up was 19 years. METHODS AND RESULTS: Four hundred forty patients (sex ratio, 1.32 [men to women]; age, 60+/-11.4 years; age range, 7 to 75 years) were operated on from 1979 to 1987. All patients underwent isolated mitral valve replacement. Tricuspid plasty was the only associated procedure. The follow-up at 19 years was 98% complete. The overall actuarial survival rate was 63+/-3.3% at 19 years, and the actuarial survival rate (only valve related) was 83+/-2.7%. The operative mortality rate (0 to 30 days) was 4.09%. We found that 89.4% of the patients alive at 19 years were in NYHA class I/II. Multivariate analysis showed that age and sex were significantly correlated with valve-related mortality and that age, sex, NYHA class, and atrial fibrillation were significantly correlated with overall mortality. The linearized rates (percent patient-years) of thromboembolism, thrombosis, and hemorrhage were 0.69, 0.2, and 1, respectively. At 19 years, freedom from endocarditis and reoperation was 98.6+/-1% and 90+/-3%, respectively. CONCLUSIONS: In this study, the very-long-term results confirm the excellent durability of the St Jude Medical prosthesis in the mitral position and show the difficulty of adjusting the anticoagulation protocol, even after long-term treatment.

Verbal aggressiveness: conceptualization and measurement a decade later.

Verbally aggressive messages attack an individual's self-concept to inflict psychological pain. Infante and Wigley developed a trait measure of Verbal aggressiveness; however, the psychometric qualities and validity of the Verbal Aggressiveness scale were not fully explored. In Study I, 119 targets (Mage = 46.2, SDage = 14.1) and 238 observers (Mage = 42.9, SD age = 14.4) participated. In Study II, 112 targets (Mage = 39.9, SDage = 12.9) and 236 observers (Mage = 37.7 SDage = 11.1) participated. In Study III, 153 college students participated (Mage = 25.9, SDage = 4.6). In these studies, temporal stability over two months, criterion-related validity (target-observer agreement), discriminant validity (employing structural equation models), and construct validity (correlations with the facet and domain scales of the NEO-Personality Inventory-R) were investigated. The results justify considering Verbal Aggressiveness as a personality trait and the Verbal Aggressiveness scale as a valid measure.