The Carpentier-Edwards bioprosthesis: a comparative study analyzing failure rates by age.
Bioprosthetic valve durability and the significance of patient age at implantation have received much attention recently. Indications and/or contraindications for implantation of the bioprosthesis in the very young and in the elderly have been reasonably well defined. Patients in the middle years (sixth and seventh decades) present a special problem in the choice of a prosthesis. To better elucidate the failure rate of the Carpentier-Edwards bioprosthesis in middle-aged patients, a comparative study of value failure rates was conducted using the Wilcoxon (Breslow) statistical technique. From September 1978 to December 1986, 502 patients underwent valve replacement with a Carpentier-Edwards bioprosthesis. All patients were operated on by a single surgical team using precisely the same method of valve implantation and myocardial preservation. The overall 30-day mortality was 8.4%. PATIENT SURVIVAL: Follow-up was obtained on all 460 hospital survivors and extends to 109.2 months with a mean of 36.8 months. The cumulative survival is 1,410.6 patient-years. VALVE SURVIVAL: The 481 patients that left the hospital were divided into two subgroups. Group I included patients aged 55 to 69 years; group II, 70 years and older. There were 8 valve failures in group I. The percent of valves free of failure plotted by the actuarial method is 95.4% at 5 years (SEM 1.7, 81 valves at risk) and 95% at 7 years (SEM 1.7, 23 valves at risk). In group II (age 70 and above), there were only two valve failures.(ABSTRACT TRUNCATED AT 250 WORDS)
Pupello
D F
DF
Department of Cardiac Surgery, St. Joseph's Heart Institute, Tampa, Florida.
Bessone
L N
LN
Hiro
S P
SP
Lopez-Cuenca
E
E
Glatterer
M S
MS
Ebra
G
G
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001705:Bioprosthesis / Q000592:standards*; D005260:Female; D005431:Florida / Q000453:epidemiology; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000145:classification / Q000401:mortality / Q000601:surgery*; D006350:Heart Valve Prosthesis / Q000009:adverse effects / Q000401:mortality / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D016019:Survival Analysis; D015996:Survival Rate