Experience with the 19-mm Carpentier-Edwards pericardial bioprosthesis in the elderly.
BACKGROUND
Valve replacement in small aortic root remains a surgical challenge. The objective of this study was to compare results of the 19-mm bioprosthesis with those of larger prostheses in the elderly.


METHODS
The 443 patients, 70 years of age and older, who underwent aortic valve replacement with Carpentier-Edwards pericardial bioprostheses were reviewed.


RESULTS
There were 93 patients with a mean age of 76+/-4 years with implantation of 19-mm prostheses and 350 patients with a mean age of 75+/-4 years with larger bioprostheses. Associated aortoplasty was performed in 10 patients (11%) with 19-mm bioprostheses and in 8 patients (2%) with larger bioprostheses (p = 0.001). There were 11 deaths (12%) within 30 days of surgery in patients with 19-mm prostheses and 22 deaths (6%) among those with larger prostheses (p = 0.1). The 7-year survival rate averaged 61%+/-7% in patients with 19-mm prostheses and 67%+/-4% in those with larger prostheses (p = 0.8). The 7-year freedom rates from all valve-related events averaged 96%+/-2% and 93%+/-2%, respectively (p = 0.6).


CONCLUSIONS
Aortic valve replacement with the 19-mm Carpentier-Edwards pericardial bioprosthesis offers excellent midterm results in the elderly.
Carrier
M
M
Department of Surgery and Medicine, Montreal Heart Institute, and the University of Montreal, Quebec, Canada. carrier@icm.umontreal.ca
Pellerin
M
M
Perrault
L P
LP
Hébert
Y
Y
Pagé
P
P
Cartier
R
R
Dyrda
I
I
Pelletier
L C
LC
D000206:Actuarial Analysis; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001705:Bioprosthesis; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000401:mortality; D011474:Prosthesis Design; D011475:Prosthesis Failure; D017755:Prosthesis Fitting; D015996:Survival Rate