Related Experiment Video

Updated: Jul 2, 2026

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
08:50

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement

Published on: March 26, 2018

Surgical management of aortic valve disease in the elderly: A retrospective comparative study of valve choice using

Kevin D Accola1, Meredith L Scott, George J Palmer

  • 1Cardiovascular Institute, Florida Hospital, Orlando, Florida, USA. KAccola@aol.com

The Journal of Heart Valve Disease
|August 30, 2008
PubMed

Insights

For elderly patients undergoing aortic valve replacement (AVR), Carpentier Edwards Perimount (CEP) bioprosthetic valves and St. Jude Medical (SJM) mechanical valves showed similar survival and cardiac event rates. Lifelong anticoagulation for mechanical valves is a key consideration.

Area of Science:

  • Cardiovascular Surgery
  • Biomaterials Science
  • Geriatric Medicine

Background:

  • Aortic valve dysfunction is the most prevalent valvular heart disease.
  • An aging population increases the number of candidates for aortic valve replacement (AVR).
  • Prosthetic valve selection is critical for patient outcomes.

Purpose of the Study:

  • To compare the outcomes of Carpentier Edwards Perimount (CEP) bioprosthetic valves and St. Jude Medical (SJM) mechanical valves in elderly patients undergoing AVR.
  • To evaluate hospital mortality, morbidity, survival rates, and late cardiac events.
  • To identify factors influencing mortality in AVR patients.

Main Methods:

  • Retrospective analysis of 801 patients (aged >=65 years) undergoing isolated AVR or AVR + CABG.
  • Comparison between CEP (n=398) and SJM (n=403) valve recipients.
  • Propensity scoring used to ensure group homogeneity and reduce bias.
  • Follow-up data collected for survival and cardiac events.

Main Results:

  • Operative mortality was 4.0% for CEP and 6.5% for SJM valves.
  • Postoperative morbidities were similar between groups.
  • Five-year actuarial survival was 70.9% for CEP and 71.8% for SJM; 10-year survival was 32.6% and 38.2%, respectively.
  • Freedom from reoperation, stroke, and myocardial infarction showed no significant differences.
  • Chronic obstructive pulmonary disease and mechanical valve replacement were predictors of late death.

Conclusions:

  • CEP and SJM valves demonstrate comparable outcomes in elderly AVR patients regarding mortality, morbidity, survival, and late cardiac events.
  • The need for lifelong anticoagulation with mechanical valves is a significant factor in prosthetic choice.
  • Careful consideration of valve type is essential for optimizing patient management.
Abstract

More Related Videos

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement14:14

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement

Published on: December 11, 2017

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots12:17

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots

Published on: May 21, 2017

Related Concept Videos

Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
Mitral Valve Prolapse II: Assessment and Management01:22

Mitral Valve Prolapse II: Assessment and Management

IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular tachycardia.
Mitral Regurgitation III: Medical Management01:25

Mitral Regurgitation III: Medical Management

Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
Mitral Valve Prolapse III: Nursing Management01:19

Mitral Valve Prolapse III: Nursing Management

The nursing management of Mitral Valve Prolapse, or MVP, centers around patient education, symptom monitoring, and lifestyle modifications.Patient Education on MVP Diagnosis and Heredity: Nurses should provide comprehensive education about MVP, a condition where the mitral valve does not close appropriately during heartbeats. This education often includes the condition's pathophysiology, symptoms, and potential complications, like arrhythmias or mitral regurgitation. Though not fully...