title: Twelve-year experience with Carpentier-Edwards PERIMOUNT pericardial valve in the mitral position: a multicenter study.
abstract: OBJECTIVE
  The study aim was to assess the durability of the Carpentier-Edwards PERIMOUNT pericardial bioprosthesis in the mitral position.
  
  
  METHODS
  This seven-center retrospective clinical study involved the follow up of 333 patients who underwent isolated mitral valve replacement and 102 patients who underwent double (mitral and aortic) valve replacement with the PERIMOUNT pericardial valve between 1984 and 1989. Mean patient age at implant was 60.7 +/- 11.6 years; 41.1% were males. The most common etiology was rheumatic heart disease (53.9%) and the most common mechanism mitral insufficiency. All patients but six were followed for an average of 7.2 +/- 3.6 years after surgery; total follow up was 3071.7 patient-years (pt-yr).
  
  
  RESULTS
  The total operative mortality rate was 7.6%; this included a valve-related mortality rate of 0.2%. The late mortality rate was 5.2% per pt-yr, of which 1.4% per pt-yr was considered valve-related. At 11 years, the overall actuarial survival rate was 53.3 +/- 2.8%, and actuarial freedom from valve-related death 83.9 +/- 2.6%. At follow up, 80% of patients were in NYHA class I or II, and 74% showed improvement. Twenty-eight incidences of deterioration requiring explant were observed. At 11 years the actuarial freedom from explant due to structural failure was 84.9 +/- 3.1%. Rates of structural failure decreased with age: the actuarial freedom from explant due to structural failure was 78.1 +/- 4.8% for patients aged < or = 60 years, 89.4 +/- 4.4% for those aged 61-70 years, and 100% for those aged over 71 years.
  
  
  CONCLUSIONS
  The Carpentier-Edwards PERIMOUNT pericardial bioprosthesis is a reliable choice when a tissue valve is required, especially in patients over 60 years of age.
authors.affiliation: Hopital Trousseau, Tours, France.
authors.forename: M
authors.initials: M
authors.lastname: Marchand
authors.forename: M
authors.initials: M
authors.lastname: Aupart
authors.forename: R
authors.initials: R
authors.lastname: Norton
authors.forename: I R
authors.initials: IR
authors.lastname: Goldsmith
authors.forename: C
authors.initials: C
authors.lastname: Pelletier
authors.forename: M
authors.initials: M
authors.lastname: Pellerin
authors.forename: T
authors.initials: T
authors.lastname: Dubiel
authors.forename: W
authors.initials: W
authors.lastname: Daenen
authors.forename: F
authors.initials: F
authors.lastname: Casselman
authors.forename: M
authors.initials: M
authors.lastname: Holden
authors.forename: T E
authors.initials: TE
authors.lastname: David
authors.forename: E A
authors.initials: EA
authors.lastname: Ryba
mesh_terms: D001705:Bioprosthesis / Q000009:adverse effects / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis / Q000009:adverse effects / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve; D011474:Prosthesis Design; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors