Carpentier-Edwards pericardial aortic valve in middle-aged patients: comparison with the St. Jude Medical valve.
OBJECTIVE
The objective of the present study was to compare long-term results of single aortic valve replacement (AVR) with mechanical (St. Jude Medical valves: standard) and biologic (the Carpentier-Edwards pericardial) prostheses.


METHODS
Between 1995 and 2002, 95 patients who underwent single AVR with mechanical (n= 46) or biologic (n= 49) prostheses were enrolled in this study. The mean age at the operation was 54.0 +/- 9.6 years (range: 20 to 69 years) with the mechanical and 68.8 +/- 7.1 years (range: 44 to 85 years) with the biologic prosthesis.


RESULTS
The 9-year actuarial survival rate, which was calculated by taking perioperative mortality into account, was 90.3 +/- 4.6% for patients with mechanical valves and 87.6 +/- 4.8% for patients with bioprostheses, with no difference between the two groups (p=0.342). The 9-year freedom rate from thromboembolism, reoperation, endocarditis was 94.8 +/- 3.6%, 100% and 97.8 +/- 2.2% for patients with mechanical valves and 98.0 +/- 2.0%, 97.5 +/- 3.4% and 95.0 +/- 3.4% for those with bioprostheses, respectively. After 9 years, freedom from cardiac death averaged 97.8% in the group with mechanical valves compared with 95.3% in those with bioprostheses (p=0.541).


CONCLUSIONS
We conclude that the mid-term durability of the Carpentier-Edwards pericardial valve in the aortic position for the elderly is excellent. Nevertheless, the risk of tissue valve reoperation progressively increases with time, and a longer follow-up may be necessary to provide its value compared with the mechanical valves in a country like Japan with a high life expectancy.
Sakamoto
Yoshimasa
Y
Department of Cardiovascular Surgery, Jikei University School of Medicine, Minato-ku, Tokyo, Japan.
Hashimoto
Kazuhiro
K
Okuyama
Hiroshi
H
Ishii
Shinichi
S
Inoue
Takahiro
T
Kinouchi
Katsushi
K
Abe
Takayuki
T
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001705:Bioprosthesis / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis / Q000009:adverse effects; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D015996:Survival Rate; D013923:Thromboembolism / Q000453:epidemiology / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome