Carpentier-Edwards pericardial aortic valve in middle-aged patients comparison with the St. Jude medical valve
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Objective
The objective of the present study was to compare long-term results of single aortic valve replacement (AVR) with mechanical (St. Jude Medical valves: standard) and biologic (the Carpentier-Edwards pericardial) prostheses. Method: Between 1995 and 2002, 95 patients who underwent single AVR with mechanical (n=46) or biologic (n=49) prostheses were enrolled in this study. The mean age at the operation was 54.0±9.6 years (range: 20 to 69 years) with the mechanical and 68.8±7.1 years (range: 44 to 85 years) with the biologic prosthesis. Results: The 9-year actuarial survival rate, which was calculated by taking perioperative mortality into account, was 90.3±4.6% for patients with mechanical valves and 87.6 ±4.8% for patients with bioprostheses, with no difference between the two groups (p=0.342). The 9-year freedom rate from thromboembolism, reoperation, endocarditis was 94.8+3.6%, 100% and 97.8 ±2.2% for patients with mechanical valves and 98.0 ±2.0%, 97.5 ±3.4% and 95.0 ±3.4% for those with bioprostheses, respectively. After 9 years, freedom from cardiac death averaged 97.8% in the group with mechanical valves compared with 95.3% in those with bioprostheses (p=0.541). Conclusion: We conclude that the mid-term durability of the Carpentier-Edwards pericardial valve in the aortic position for the elderly is excellent. Nevertheless, the risk of tissue valve reoperation progressively increases with time, and a longer follow-up may be necessary to provide its value compared with the mechanical valves in a country like Japan with a high life expectancy. (Jpn J Thorac Cardiovasc Surg 2005; 53:465-469)
Key words
valve disease mid-term results aortic valve replacementPreview
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References
- 1.Cosgrove DM, Lytle BW, Taylor PC, Camacho MT, Stewart RW, McCarthy PM, et al. The Carpentier-Edwards pericardial aortic valve: Ten-year results. J Thorac Cardiovasc Surg 1995; 110: 651–62.CrossRefPubMedGoogle Scholar
- 2.Pelletier LC, Carrier M, Leclerc Y, Dyrda I. The Carpentier-Edwards pericardial bioprosthesis: Clinical experience with 600 patients. Ann Thorac Surg 1995; 60 (2 Suppl): S297–302.CrossRefPubMedGoogle Scholar
- 3.Aupart MR, Dreyfus XB, Meurisse YA, Rouchet SC, Sirinelli AL, May MD, et al. The influence of age on valve related events with Carpentier-Edwards pericardial valves. J Cardiovasc Surg (Torino) 1995; 36: 297–302.Google Scholar
- 4.Banbury MK, Cosgrove DM 3rd, Lytle BW, Smedira NG, Sabik JF, Saunders CR. Long-term results of the Carpentier-Edwards pericardial aortic valve: A 12-year follow-up. Ann Thorac Surg 1998; 66 (6 Suppl): S73–6.CrossRefPubMedGoogle Scholar
- 5.Neville PH, Aupart MR, Diemont FF, Sirinelli AL, Lemoine EM, Marchand MA. Carpentier-Edwards pericardial bioprosthesis in aortic or mitral position: A 12-year experience. Ann Thorac Surg 1998; 66 (6 Suppl): S143–7.CrossRefPubMedGoogle Scholar
- 6.Poirer NC, Pelletier LC, Pellerin M, Carrier M. 15-year experience with the Carpentier-Edwards pericardial bioprosthesis. Ann Thorac Surg 1998; 66 (6 Suppl): S57–61.CrossRefPubMedGoogle Scholar
- 7.Frater RW, Furlong P, Cosgrove DM, Okies JE, Colburn LQ, Katz AS, et al. Long-term durability and patient functional status of the Carpentier-Edwards Perimount pericardial bioprosthesis in the aortic position. J Heart Valve Dis 1998; 7: 48–53.PubMedGoogle Scholar
- 8.Banbury MK, Cosgrove DM 3rd, White JA, Blackstone EH, Frater RW, Okies JE. Age and valve size effect on the long-term durability of the Carpentier-Edwards aortic pericardial bioprosthesis. Ann Thorac Surg 2001; 72: 753–7.CrossRefPubMedGoogle Scholar
- 9.Dellgren G, David TE, Raanani E, Armstrong S, Ivanov J, Rakowski H. Late hemodynamic and clinical outcomes of aortic valve replacement with the Carpentier-Edwards Perimount pericardial bioprosthesis. J Thorac Cardiovasc Surg 2002; 124: 146–54.CrossRefPubMedGoogle Scholar
- 10.Biglioli P, Spampinato N, Cannata A, Musumeci A, Parolari A, Gagliardi C, et al. Long-term outcomes of the Carpentier-Edwards pericardial valve prosthesis in the aortic position: Effect of patient age. J Heart Valve Dis 2004; 13 Suppl 1: S49–51.Google Scholar
- 11.Edmunds LH Jr, Clark RE, Cohn LH, Grunkemeier GL, Miller DC, Weisel RD. Guidelines for reporting morbidity and mortality after cardiac valvular operations. The American Association for Thoracic Surgery, Ad Hoc Liaison Committee for Standardizing Definitions of Prosthetic Heart Valve Morbidity. Ann Thorac Surg 1996; 62: 932–5.CrossRefGoogle Scholar
- 12.Hammermeister KE, Sethi GK, Henderson WG, Oprian C, Kim T, Rahimtoola S. A comparison of outcomes in men 11 years after heart-valve replacement with a mechanical valve or bioprosthesis. Veterans Affairs Cooperative Study on Valvular Heart Disease. N Engl JMed 1993; 328: 1289–96.CrossRefGoogle Scholar
- 13.Khan SS, Trento A, DeRobertis M, Kass RM, Sandhu M, Czer LS, et al. Twenty-year comparison of tissue and mechanical valve replacement. J Thorac Cardiovasc Surg 2001; 122: 257–69.CrossRefPubMedGoogle Scholar
- 14.Carrier M, Pellerin M, Perrault LP, Page P, Hebert Y, Cartier R, et al. Aortic valve replacement with mechanical and biologic prosthesis in middle-aged patients. Ann Thorac Surg 2001; 71 (5 Suppl): S253–6.CrossRefPubMedGoogle Scholar
- 15.Jamieson WR, Miyagishima RT, Grunkemeier GL, Germann E, Henderson C, Lichtenstein SV, et al. Bileaflet mechanical prostheses for aortic valve replacement in patients younger than 65 years and 65 years of age or older: Major thromboembolic and hemorrhagic complications. Can J Surg 1999; 42: 27–36.PubMedPubMedCentralGoogle Scholar
- 16.Banbury MK, Cosgrove DM 3rd, Thomas JD, Blackstone EH, Rajeswaran J, Okies JE, et al. Hemodynamic stability during 17 years of the Carpentier-Edwards aortic pericardial bioprosthesis. Ann Thorac Surg 2002; 73: 1460–5.CrossRefPubMedGoogle Scholar