Long-Term Outcomes After TTK Chitra Mechanical Heart Valve Implantation: a 20-Year Experience of Implantation in 2272 Consecutive Patients from a Single Tertiary Centre in India

There is little data available on the long-term outcomes of mechanical valve replacement from the developing world. The aim of this study was to determine long-term survival and outcomes following mechanical valve replacement with the TTK Chitra valve at a single Indian centre. A clinical observational study was conducted in a cohort of 2272 consecutive patients who had undergone mechanical valve replacement with the TTK Chitra Heart Valve between 2001 and 2020. Follow-up was 89.3% complete with a mean follow-up of 7.1 (SD 5) years. The primary end point was survival. Regression and life table analyses were used to determine population survival and attributable risk. Secondary end points were reintervention and valve-related complications. Overall actuarial survival was 82.3 (SD1) %, 70.7 (SD1) %, and 61 (SD2) % at 1, 5, and 10 years, respectively, lower than published data in comparable patients from the developed world. Actuarial freedom from prosthetic valve dysfunction was 99 (SD1) %, 96.3 (SD1) %, and 96 (SD1)% at 1, 5, and 10 years, respectively. Freedom from reintervention was 91.2 (SD1) %, 90.4 (SD1) %, and 90 (SD1) % at 1, 5, and 10 years, respectively. Actuarial freedom from major adverse prosthesis–related events was 83% (SD0.8) %, 66.9 (SD1) %, and 50.1 (SD1.7) % at 1, 5, and 10 years, respectively, and actuarial freedom from major haemorrhage was 85.5 (SD0.7) %, 70.7 (SD1) %, and 57.3 (SD1.7) % at 1, 5, and 10 years, respectively. The TTK Chitra valve continues to remain the preferred prosthesis of choice for many patients in India, and the developing world by virtue of performance, durability, and cost; however, long-term valve care continues to plague the real benefits and outcomes it has to offer.