title: Experience with 813 aortic or mitral valve replacements with the Carpentier-Edwards bioprosthesis: Five year results.
abstract: 813 patients underwent aortic (AVR) or mitral valve replacement using the Carpentier-Edwards bioprosthesis from 1976 to 1983. Operative mortality was 5.49% for AVR and 4.59% for MVR. Late mortality and complications were classified using criteria described by the Stanford Group. Actuarial survival at 5 years was 87.9% +/- 2.7% for AVR and 91.1% +/- 1.4% in MVR. Thromboembolism occurred at low rates of 0.48% pt yr for AVR and 0.90% pt yr for MVR. 98.2% +/- 0.90% of AVR and 96.9% +/- 1.3% of MVR pts were free from thromboembolism at 5 years. The low incidence of thromboembolism during the early postoperative period played a role in the low rates observed in the complete study. There was no valve thrombosis. Anticoagulation with warfarin was used in 35% AVR and 75% MVR with rates of bleeding complications of 1.20% pt yr and 1.10% pt yr. Overall valve failure rate was 2.04% pt yr at 5 years for AVR and 1.55% pt yr for MVR. Rates of reoperation for tissue failure remained low (0.24% pt yr for AVR and 0.32% pt yr for MVR). The advantage of a low rate of thromboembolism was not outweighed by the specific problems of bioprosthesis at 5 years.
mesh_terms: D000206:Actuarial Analysis; D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D001021:Aortic Valve / Q000601:surgery; D001705:Bioprosthesis / Q000009:adverse effects* / Q000401:mortality; D004696:Endocarditis / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis / Q000009:adverse effects* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D011474:Prosthesis Design; D012086:Reoperation; D013923:Thromboembolism / Q000209:etiology*; D013997:Time Factors
chemical_list: D000925:Anticoagulants