Experience with the 19-mm Carpentier-Edwards pericardial bioprosthesis in the elderly

Background. Valve replacement in small aortic root remains a surgical challenge. The objective of this study was to compare results of the 19-mm bioprosthesis with those of larger prostheses in the elderly. Methods. The 443 patients, 70 years of age and older, who underwent aortic valve replacement with Carpentier-Edwards pericardial bioprostheses were reviewed. Results. There were 93 patients with a mean age of 76 +/- 4 years with implantation of 19-mm prostheses and 350 patients with a mean age of 75 +/- 4 years with larger bioprostheses. Associated aortoplasty was performed in 10 patients (11%) with 19-mm bioprostheses and in 8 patients (2%) with larger bioprostheses (p = 0.001). There were 11 deaths (12%) within 30 days of surgery in patients with 19-mm prostheses and 22 deaths (6%) among those with larger prostheses (p = 0.1). The 7-year survival rate averaged 61% +/- 7% in patients with 19-mm prostheses and 67% +/- 4% in those with larger prostheses (p = 0.8). The 7-year freedom rates from all valve-related events averaged 96% +/- 2% and 93% +/- 2%, respectively [p = 0.6). Conclusions. Aortic valve replacement with the 19-mm Carpentier-Edwards pericardial bioprosthesis offers excellent midterm results in the elderly. (C) 2001 by The Society of Thoracic Surgeons.