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Aortic Valve Replacement With Carpentier-Edwards: Hemodynamic Outcomes for the 19-mm Valve

Ji Hoon You1, Dong Seop Jeong2, Kiick Sung2

  • 1Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Thoracic and Cardiovascular Surgery, Seoul Veterans Hospital, Seoul, Korea.

The Annals of Thoracic Surgery
|February 14, 2016
PubMed

Insights

The 19-mm Carpentier-Edwards pericardial bioprosthesis shows acceptable hemodynamic performance and clinical outcomes in aortic stenosis patients. This small bioprosthesis is comparable to larger valves, with no significant differences in survival or complications.

Area of Science:

  • Cardiovascular Surgery
  • Biomedical Engineering
  • Clinical Outcomes Research

Background:

  • Aortic stenosis necessitates aortic valve replacement (AVR).
  • The Carpentier-Edwards pericardial bioprosthesis is a common AVR option.
  • Comparisons between smaller (19-mm) and larger bioprostheses are crucial for optimizing patient outcomes.

Purpose of the Study:

  • To compare the hemodynamic performance and clinical outcomes of the 19-mm Carpentier-Edwards pericardial bioprosthesis against larger valves in patients with aortic stenosis.
  • To evaluate the impact of patient-prosthesis mismatch on outcomes.

Main Methods:

  • A retrospective study of 447 patients undergoing AVR for aortic stenosis between 1998 and 2013.
  • Patients were grouped by implanted valve size: 19-mm (n=54), 21-mm (n=154), and 23-27 mm (n=239).
  • Transthoracic echocardiography assessed in vivo effective orifice area index at 12 months; mean follow-up was 4.9 years.

Main Results:

  • Overall survival at 10 years was 84.1%, unaffected by patient-prosthesis mismatch.
  • The 19-mm group, despite being older and having more mismatch, showed no significant differences in early outcomes, survival, or cardiac mortality compared to larger valves.
  • Independent mortality risk factors included age, male gender, coronary artery bypass graft, and low hemoglobin.

Conclusions:

  • The Carpentier-Edwards pericardial bioprosthesis, including the 19-mm size, demonstrates acceptable clinical outcomes and hemodynamic function.
  • Smaller bioprostheses can be safely used in selected patients with aortic stenosis.
  • Further research may explore long-term durability and specific patient selection criteria.
Abstract

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