title: Aortic valve replacement with the Cardioprotese Premium bovine pericardium bioprosthesis: four-year clinical results.
abstract: OBJECTIVE
  This study reports the initial clinical and echocardiographic results of the Premium bioprosthetic aortic valve up to 4 years of follow-up.
  
  
  METHODS
  Between October 2007 and July 2011, 121 consecutive patients were submitted for aortic valve replacement with the Premium bioprosthetic valve. The mean age was 68 ± 9 years and 64 patients were males. The patients were periodically evaluated by clinical and echocardiographic examinations. The mean follow-up was 21 months (min = 2, max = 48), yielding 217 patients/year for the analysis.
  
  
  RESULTS
  The hospital mortality was 8%. Late survival at 3 years was 89% (95% CI: 81.9-93.3%), and 80% of the patients were in NYHA functional class I/II. The rates of valve-related complications were low, with a linearized incidence of 0.9%/100 patients/year for thromboembolic complications, 0% for haemorrhagic events and 0.9%/100 patients/year of bacterial endocarditis. There was no case of primary structural valve dysfunction. The mean effective orifice area was 1.61 ± 0.45 cm(2); mean gradient 13 ± 5 mmHg and peak gradient 22 ± 9 mmHg. Significant patient-prosthesis mismatch was found in only 11% of the cases.
  
  
  CONCLUSIONS
  The Premium bioprosthetic aortic valve demonstrated very satisfactory clinical and echocardiographic results up to 4 years, similar to other commercially available, third-generation bioprosthetic valves.
authors.affiliation: Division of Cardiovascular Surgery,  Santa Casa de Misericórdia de Curitiba-PUCPR and Instituto de Neurologia e Cardiologia de Curitiba, Paraná,  Brazil.
authors.forename: Fábio Rocha
authors.initials: FR
authors.lastname: Farias
authors.forename: Francisco Diniz Affonso
authors.initials: FD
authors.lastname: da Costa
authors.forename: Eduardo Mendel
authors.initials: EM
authors.lastname: Balbi Filho
authors.forename: Daniele de Fátima
authors.initials: Dde F
authors.lastname: Fornazari
authors.forename: Claudinei
authors.initials: C
authors.lastname: Collatusso
authors.forename: Andreia Dumsch de Aragon
authors.initials: AD
authors.lastname: Ferreira
authors.forename: Sergio Veiga
authors.initials: SV
authors.lastname: Lopes
authors.forename: Tadeu Augusto
authors.initials: TA
authors.lastname: Fernandes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D001705:Bioprosthesis; D001938:Brazil; D002417:Cattle; D018572:Disease-Free Survival; D005260:Female; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D006351:Heart Valves; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000637:transplantation*; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D011474:Prosthesis Design; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography