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Carpentier-Edwards supraannular porcine bioprosthesis in aortic position: 16-year experience
H Corbineau1, B De La Tour, J P Verhoye
1Department of Cardiovascular and Thoracic Surgery, University Hospital Center, Rennes, France. herve.corbineau@chu-rennes.fr
Background:
The aim of the study was to evaluate the long-term results of aortic valve replacement with the Carpentier-Edwards supraannular porcine bioprosthesis.
Methods:
A total of 278 patients who underwent aortic valve replacement between January 1983 and December 1986 were reviewed. Mean age was 69.4+/-11.0 years (range 24 to 90 years).
Results:
The operative mortality was 8.6% (24 patients). The total follow-up was 2367.1 years (mean 9.3+/-4.3 years, maximum 15.5). The late mortality rate was 6.8%/patient-year (162 patients) and the overall survival at 15 years was 26.5%+/-3.6%. Structural valve deterioration (SVD) occurred in 19 patients (linearized rate 0.8%/ patient-year). The mean time to onset of deterioration was 10.9+/-2.9 years. This time was independent of the age at the time of implantation. The freedom from SVD at 10, 12, and 15 years for patients aged less than 60 was respectively 87.6%+/-6.8%, 77.8%+/-8.9%, and 44.2%+/-12.9% (linearized rate 3.3%/patient-year). For patients aged 61 to 70 years, freedom from SVD was, respectively, 100%, 97.3%+/-2.1%, and 80.8%+/-8.3% (linearized rate 0.63% patient-year). For patients older than 70 years, it was respectively 99.1%+/-0.9%, 95.6%+/-2.6%, and 93.3%+/-3.3% (linearized rate 0.31%/patient-year). No significant difference was observed below the age of 60 years (< or =50 vs 51 to 60 years) or in the older subgroups (61 to 70 years, vs >70 years).
Conclusions:
The Carpentier-Edwards supraannular bioprosthesis in aortic position provides low rate of structural valve deterioration at 15 years in patients aged more than 60 years at the time of implantation. The mean time to onset of SVD is independent of the subject's age at the time of implantation. After 60 years, the risk of deterioration is low and does not present any significant variation. The Carpentier-Edwards supraannular bioprosthesis can reliably be used for aortic valve replacement in patients over the age of 60 years because, beyond this age, SVD is observed much more rarely.