Late Outcomes for Aortic Valve Replacement With the Carpentier-Edwards Pericardial Bioprosthesis: Up to 17-Year Follow-Up in 1,000 Patients

被引:135
作者
McClure, R. Scott
Narayanasamy, Narendren
Wiegerinck, Esther
Lipsitz, Stuart
Maloney, Ann
Byrne, John G.
Aranki, Sary F.
Couper, Gregory S.
Cohn, Lawrence H. [1 ]
机构
[1] Brigham & Womens Hosp, Div Cardiac Surg, Boston, MA 02115 USA
关键词
20-YEAR EXPERIENCE; DURABILITY;
D O I
10.1016/j.athoracsur.2010.01.046
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. This study reviews a single institution experience with the Carpentier-Edwards pericardial aortic valve bioprosthesis, concentrating on late outcomes. Methods. From December 1991 to June 2002, 1,000 patients underwent aortic valve replacement with the Carpentier-Edwards pericardial valve (mean follow-up 6.01 +/- 3.56 years). The institutional database was reviewed. Follow-up data were acquired through telephone interviews and mail-in questionnaires. Time-toevent analyses were performed by the Kaplan-Meier method. Mean age was 74.1 years; 545 patients (54.5%) were male. Mean preoperative ejection fraction was 52.5%. Isolated aortic valve replacement occurred in 372 cases (37.2%). Combined aortic valve replacement with coronary artery bypass grafting occurred in 443 cases (44.3%). The remaining 185 patients (18.5%) underwent complex procedures with concomitant mitral, tricuspid, or arch repair. One hundred forty patients (14.0%) had prior aortic valve surgery. Follow-up was 99.4% complete. Results. Overall operative mortality was 7.2% (72 of 1,000). There were 503 late deaths (50.3%). Age-stratified survival at 15 years was 43.7% for patients less than 65 years of age; 18.2% for patients aged 65 to 75; and 9.4% for patients aged more than 75 years. There were 26 failed bioprostheses (2.6%) requiring reoperation. Structural valve deterioration was the cause in 13 of 26 cases (50%), endocarditis in 11 of 26 (42%), and perivalvular leak in 2 of 26 (7.6%). Age-stratified freedom from reoperation due to structural valve deterioration at 15 years was 34.7% for patients less than 65 years of age; 89.4% for patients aged 65 to 75; and 99.5% for patients aged more than 75 years. Conclusions. The Carpentier-Edwards pericardial bioprosthesis shows long-term durability with low rates of structural failure. (Ann Thorac Surg 2010;89:1410-6) (C) 2010 by The Society of Thoracic Surgeons
引用
收藏
页码:1410 / 1416
页数:7
相关论文
共 22 条
[1]  
Akins CW, 2008, ANN THORAC SURG, V85, P1490, DOI [10.1016/j.athoracsur.2007.12.082, 10.1016/j.ejcts.2007.12.055]
[2]  
Bach DS, 2007, J HEART VALVE DIS, V16, P649
[3]   Age and valve size effect on the long-term durability of the Carpentier-Edwards aortic pericardial bioprosthesis [J].
Banbury, MK ;
Cosgrove, DM ;
White, JA ;
Blackstone, EH ;
Frater, RWM ;
Okies, JE .
ANNALS OF THORACIC SURGERY, 2001, 72 (03) :753-757
[4]  
Biglioli P, 2004, J HEART VALVE DIS, V13, pS49
[5]   Stentless aortic valve reoperations: A surgical challenge [J].
Borger, Michael A. ;
Prasongsukarn, Kriengchai ;
Armstrong, Susan ;
Feindel, Christopher M. ;
David, Tirone E. .
ANNALS OF THORACIC SURGERY, 2007, 84 (03) :737-744
[6]  
Chambers JC, 1997, CIRCULATION, V96, P2206
[7]  
Cosgrove D M, 1996, Semin Thorac Cardiovasc Surg, V8, P269
[8]   Aortic valve replacement with Toronto SPV bioprosthesis: Optimal patient survival but suboptimal valve durability [J].
David, Tirone E. ;
Feindel, Christopher M. ;
Bos, Joanne ;
Ivanov, Joan ;
Armstrong, Susan .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2008, 135 (01) :19-24
[9]   Ross Operation in the Adult: Long-Term Outcomes After Root Replacement and Inclusion Techniques [J].
de Kerchove, Laurent ;
Rubay, Jean ;
Pasquet, Agnes ;
Poncelet, Alain ;
Ovaert, Caroline ;
Pirotte, Manuel ;
Buche, Michel ;
D'Hoore, William ;
Noirhomme, Philippe ;
El Khoury, Gebrine .
ANNALS OF THORACIC SURGERY, 2009, 87 (01) :95-102
[10]   Late hemodynamic and clinical outcomes of aortic valve replacement with the Carpentier-Edwards Perimount pericardial bioprosthesis [J].
Dellgren, G ;
David, TE ;
Raanani, E ;
Armstrong, S ;
Ivanov, J ;
Rakowski, H .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2002, 124 (01) :146-154