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European Journal of Cardio-Thoracic Surgery, Vol 10, 879-883, Copyright © 1996 by European Association for Cardio-thoracic Surgery
M Aupart, I Simonnot, A Sirinelli, Y Meurisse, D Babuty and M Marchand
OBJECTIVE: The first generation of pericardial valves was withdrawn from
the market because of too high a rate of premature failure. With an
original design, the Carpentier-Edwards pericardial valve promised improved
results, especially in small sizes. METHODS: Ninety patients who underwent
an isolated aortic valve replacement with a 19 mm Carpentier-Edwards
pericardial bioprosthesis in our institution between July 1984 and December
1993 were followed up. The mean age was 72.2 +/- 10.1 years. Fifty percent
of the patients were in NYHA clinical status III or IV. The operative
mortality rate was 3.7% (3/90). All patients were followed up for an
average of 4.45 years after their operation and the total follow-up was 398
patient-years. RESULTS: At this time of the study, over 80% of the patients
are in NYHA class I or II. There were nine late deaths. After 10 years the
actuarial survival rate was 80 +/- 12%. Three patients died of
valve-related causes (1 endocarditis, 1 structural failure and 1 sudden
death). The actuarial rate of freedom from valve-related death was 93 +/-
6% at 10 years. Valve-related complications included two thromboembolic
episodes (0.5% patient-year), one endocarditis (0.3% patient-year), one
reoperation (0.3% patient- year) and one structural valve failure with
calcification and stenosis (0.3% patient-year). After 10 years, freedom
from reoperation was 99 +/- 1%, from valve failure 98 +/- 2%, from
thromboembolic episodes 95 +/- 4% and from endocarditis 98 +/- 2%. The mean
gradient was 18.8 mmHg and mean effective orifice area 1.1 cm2.
CONCLUSIONS: With a low rate of valve-related events at 10 years and a low
rate of structural deterioration with no leaflet tear, this prosthesis is a
reliable alternative for small aortic annuli.
ARTICLES
Pericardial valves in small aortic annuli: ten years' results
Department of Cardiac Surgery, Trousseau University Hospital, Tours, France.
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