Aortic valve replacement with the Carpentier-Edwards Perimount bioprosthesis: Clinical and hemodynamic evaluation

The number of aortic valve replacement (AVR) surgeries has increased recently, along with the number of bioprosthetic valves implantations. Several studies reported excellent durability and low incidence of valve-related complications with the Carpentier-Edwards Perimount (CEP) pericardial bioprosthesis. The aim of this study is to evaluate the hemodynamic performance and clinical outcomes of the CEP in the aortic position.

This retrospective study included all patients who underwent AVR using the CEP valve from January 2010 to December 2010 at our institution. Clinical, surgical and early echocardiographic data were retrospectively collected. Survival was the primary endpoint. Median follow-up was 6.5 years. Hemodynamic profile was evaluated by echocardiography 3±1 months after AVR.

Out of 175 patients, 50% were male and the mean age was 70.8+8.8 years. We registered a relatively low rate of complications: 2.2% permanent pacemaker implantation; 32.2% post-operative atrial fibrillation episodes; 1.1% stroke. The 30-day mortality rate was 5.1%. One patient underwent reoperation to replace the CEP bioprosthesis due to endocarditis (0.6%). Overall survival rates at 1, 3, 5 and 7 years were 93.4, 82.5, 75.3, and 62.3%, respectively. No significant differences were found between 7-year survival rates for isolated AVR and multiple procedures (67.8% vs. 61.8%, Log-Rank test, p=0.286). Post-operative mean transvalvular gradient was 15.5±4.8 mmHg and EOA 1.6±0.3 cm2.

The CEP bioprosthesis in the aortic position shows acceptable mid-term clinical results and hemodynamic profile that support its clinical use.