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Commissural region dehiscence from the stent post of Carpentier-Edwards bioprosthetic cardiac valves.

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Bioprostheses for cardiac valve replacement.

W R Jamieson

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    |November 1, 1985
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    Summary
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    Biologic tissue valves offer excellent quality of life for cardiac patients. New-generation bioprostheses show promise in reducing complications compared to standard tissue valves.

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    Area of Science:

    • Cardiovascular Surgery
    • Biomaterials Science
    • Prosthetic Devices

    Background:

    • Biologic tissue has been a successful material for cardiac valve substitutes since 1969.
    • Assessing prosthetic valve performance involves evaluating thromboembolism, hemorrhage, endocarditis, and failure.

    Purpose of the Study:

    • To evaluate the clinical performance of previous and new-generation Carpentier-Edwards porcine bioprostheses.
    • To illustrate methods for assessing valve performance, including linearized occurrence rates and multiple decrement analysis.

    Main Methods:

    • Utilized linearized occurrence rates and multiple decrement analysis to assess valve-related complications.
    • Compared standard and new-generation Carpentier-Edwards porcine bioprostheses.

    Main Results:

    • The standard valve had a complication rate of 2.9% per patient-year over 5 years; the new-generation prosthesis had a rate of 4.3% per patient-year over 2 years.
    • Thromboembolism rates were 1.6% and 1.7% per patient-year for standard and new-generation prostheses, respectively.
    • Primary tissue failure occurred at 0.6% per patient-year in the standard prosthesis only.

    Conclusions:

    • Standardized assessment of prosthetic performance aids in optimizing patient management.
    • New-generation biologic prostheses with improved preservation techniques are expected to reduce calcification and fatigue.
    • Biologic tissue valves provide patients with a high quality of life and a low incidence of valve-related complications.