title: Single center experience with the Sorin Bicarbon prosthesis: a 17-year clinical follow-up.
abstract: OBJECTIVE
  To evaluate the long-term results of aortic valve replacement (AVR) and mitral valve replacement (MVR) with the Sorin Bicarbon prosthesis (SBP).
  
  
  METHODS
  Five hundred seven patients (306 men, 201 women), mean age 62±10 years (range, 21-86 years), received an SBP between 1994 and 2000; AVR was performed in 344 (67%) and MVR in 163 (33%). The main concomitant procedure was coronary artery grafting in 79 patients (16%). Follow-up was 99% complete; mean follow-up was 12.7±4.0 years with a cumulative duration of follow-up of 6475 patient-years in the entire group (4348 patient-years for AVR and 2124 patient-years for MVR).
  
  
  RESULTS
  Hospital mortality was 2.7% (AVR, 2.03%; MVR, 4.3%). There were 169 late deaths (AVR, 128; MVR, 41). Actuarial survival at 17 years is 49.7%±5.3% for AVR and 62.0%±6.1% for MVR. At the last follow-up, 310 survivors (199 AVR, 111 MVR) are in New York Heart Association functional class I or II. At 17 years, actuarial freedom from valve-related deaths, embolism, and bleeding is 89.8%±4.8%, 85.8%±5.4%, and 96.2%±1.2% after AVR, and 91.9%±3.9%, 96.3%±1.8%, 95.0%±2.9% after MVR. Reoperation was required in 5 patients with AVR (thrombosis in 4 and perivalvular leak in 1). Actuarial freedom from reoperation is 98.1%±0.8% after AVR and 100% after MVR; freedom from endocarditis is 100% after AVR and 99.2%±0.7% after MVR. No cases of intrinsic structural valve failure were observed.
  
  
  CONCLUSIONS
  The SBP has shown excellent results in terms of clinical improvement and freedom from valve-related complications, even up to 17 years after AVR and MVR. It therefore seems to be a safe option whenever a mechanical prosthesis is needed.
authors: Section of Cardiac Surgery, University Hospital, Pisa, Italy.
authors: Michele
authors: M
authors: Celiento
authors: Section of Cardiac Surgery, University Hospital, Pisa, Italy.
authors: Luca
authors: L
authors: Filaferro
authors: Division of Cardiac Surgery, University of Verona, Verona, Italy.
authors: Aldo D
authors: AD
authors: Milano
authors: Section of Cardiac Surgery, University Hospital, Pisa, Italy.
authors: Gerardo
authors: G
authors: Anastasio
authors: Section of Cardiac Surgery, University Hospital, Pisa, Italy.
authors: Gabriele
authors: G
authors: Ferrari
authors: Section of Cardiac Surgery, University Hospital, Pisa, Italy. Electronic address: uberto.bortolotti@med.unipi.it.
authors: Uberto
authors: U
authors: Bortolotti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000503:physiopathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D007558:Italy; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000503:physiopathology / Q000601:surgery*; D018579:Patient Selection; D011183:Postoperative Complications / Q000401:mortality / Q000628:therapy; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult