Comparison of long-term results of Carpentier-Edwards and Hancock bioprosthetic valves
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Long-term survival after heart valve replacement showed comparable outcomes for Carpentier-Edwards and Hancock bioprostheses. Both valve types demonstrated similar actuarial survival and freedom from complications in this patient cohort.
Area of Science:
- Cardiovascular Surgery
- Biomedical Engineering
- Clinical Outcomes Research
Background:
- Heart valve replacement is a critical procedure for managing valvular heart disease.
- Bioprosthetic valves, such as Carpentier-Edwards and Hancock models, are commonly used.
- Long-term comparative data on survival and complications are essential for clinical decision-making.
Purpose of the Study:
- To compare the long-term survival and valve-related complications between Carpentier-Edwards and Hancock bioprosthetic heart valves.
- To evaluate the performance of these bioprostheses in both aortic and mitral positions.
Main Methods:
- A nonrandomized study comparing 407 patients who underwent valve replacement between 1974 and a later follow-up period.
- Actuarial survival rates and probability of freedom from death and valve removal were calculated.
- Statistical analysis was performed to determine significant differences between the two valve types.
Main Results:
- Actuarial survival at 5 and 8 years was high for both Carpentier-Edwards (94%, 93%) and Hancock (89%, 83%) valves, with no significant difference (p=NS).
- Freedom from death and valve removal at 5 and 8 years was also comparable between the two valve types (p=NS).
- An accelerated attrition rate was noted for both valves in the mitral position, though differences between valves were not significant.
Conclusions:
- Carpentier-Edwards and Hancock bioprosthetic heart valves demonstrate similar long-term survival and freedom from major complications.
- Valve position (aortic vs. mitral) did not significantly alter the comparative outcomes between these two bioprostheses.
- Both bioprosthetic valve types offer acceptable long-term performance in valve replacement surgery.
Abstract:
The long-term survival following valve replacement with Carpentier-Edwards or Hancock bioprostheses was compared between the two valve models and between the two groups totaling 407 patients who were discharged after valve replacement beginning in 1974. The two groups of patients were treated in a nonrandomized fashion. The actuarial survival for 299 patients with Carpentier-Edwards valves was 94 +/- 1.5% (+/- standard error) and 93 +/- 1.7% after 5 and 8 years of follow-up, respectively. Comparable figures for 108 patients undergoing valve replacement with Hancock valves were 89 +/- 3.0% and 83 +/- 3.7%, respectively (p = not significant [NS]). The probability of freedom from death and valve removal after 5 and 8 years of follow-up was 91 +/- 1.8% and 79 +/- 4.6%, respectively, with the Carpentier-Edwards valve and 84 +/- 3.5% and 75 +/- 4.3%, respectively, with the Hancock valve (p = NS). An accelerated rate of attrition for both valves was observed in the mitral position. There were no significant differences in actuarial survival between the two valves in the mitral or the aortic position or in the incidence of major valve-related complications.