title: Long-term results of the carpentier-edwards supraannular aortic valve prosthesis.
abstract: BACKGROUND
  We evaluate the clinical results of the Carpentier-Edwards supraannular (CE SAV) aortic bioprosthesis at long-term follow-up (over 25 years).
  
  
  METHODS
  Between 1983 and 1994, 1,002 CE SAV prostheses were implanted. Data were prospectively collected, retrospectively analyzed, and stratified by age groups at the time of surgery (group 1, ≤60 years; group 2, 61 to 70 years; group 3, >70 years), using both the actuarial and the "actual" (cumulative risk) methods.
  
  
  RESULTS
  The operative mortality was 11.3% (valve-related in 2 cases). Follow-up included 8,164.09 patient-years (average 13.7±6.6 years, up to 26.9 years). Overall survival at 25 years was significantly higher in group 1 (p<0.001). Freedom from structural valve deterioration (SVD) at 15 years was 85.9% (actuarial) and 94.8% (actual). Freedom from reoperation for SVD was 91.8% (actuarial) and 97% (actual). There were no significant differences in valve-related endpoints among group 2 and group 3. Death was valve-related in 11.3%. Younger age at surgery was associated with higher incidence but not earlier presentation of SVD. Freedom from any valve-related complication at 15 years was 23.6%, 66%, and 68% in groups 1, 2, and 3 (actuarial), and 38.9%, 76.1%, and 81.2%, respectively (actual) (p=0.6 among groups 2 and 3).
  
  
  CONCLUSIONS
  The CE SAV bioprosthesis provides similar outcomes (SVD and reoperation) in patients aged 61 to 70 years and older individuals. Use of a bioprosthesis is justified in patients older than 60 years. Younger patients may be rightfully informed over the expected durability of the prosthesis.
authors: Division of Cardiovascular and Thoracic Surgery, Pontchaillou Hospital, Rennes, France. gianvito_ruggieri@libero.it
authors: Vito Giovanni
authors: VG
authors: Ruggieri
authors: Erwan
authors: E
authors: Flecher
authors: Amedeo
authors: A
authors: Anselmi
authors: Bernard
authors: B
authors: Lelong
authors: Hervé
authors: H
authors: Corbineau
authors: Jean-Philippe
authors: JP
authors: Verhoye
authors: Thierry
authors: T
authors: Langanay
authors: Alain
authors: A
authors: Leguerrier
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D001705:Bioprosthesis; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006349:Heart Valve Diseases / Q000401:mortality / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome