title: Long-term outcome of the carpentier-edwards pericardial valve in the aortic position in Japanese patients.
abstract: BACKGROUND
  According to the Japanese Circulation Society guidelines, a bioprosthesis is recommended for aortic valve replacement (AVR) in patients aged ≥65 years who have no risk factors for thromboembolism. There are few data, however, regarding the actual durability of bioprosthetic valves in Japanese patients. The purpose of this study was to assess the long-term durability of Carpentier-Edwards pericardial (CEP) valves in Japanese AVR patients, and to assess the risk factors for reoperation due to structural valve deterioration (SVD).
  
  
  RESULTS
  From 1986 to 2001, a total of 591 patients underwent AVR with CEP valves in 9 hospitals. Of these, 574 patients (mean age, 71.9±8.5 years) were analyzed in this study. There were 26 in-hospital deaths (4.5%). The 10-year follow-up rate was 82.6% and the median follow-up time was 9.2 years. Freedom from reoperation due to SVD was 99.5%, 96.7%, and 87.5% at 5, 10, and 15 years, respectively. Factors that raised the risk of reoperation due to SVD included younger age at operation and history of prior operation. In patients aged ≥65 years, freedom from reoperation due to SVD was 94.4% at 15 years.
  
  
  CONCLUSIONS
  The durability of CEP valves in patients with AVR was excellent, especially in elderly patients. Thus, it seems appropriate to follow the current Japanese Circulation Society recommendations for the use of bioprosthetic valves.
authors.affiliation: Kyoto University Graduate School of Medicine.
authors.forename: Kenji
authors.initials: K
authors.lastname: Minakata
authors.forename: Shiro
authors.initials: S
authors.lastname: Tanaka
authors.forename: Yohei
authors.initials: Y
authors.lastname: Okawa
authors.forename: Mitsuomi
authors.initials: M
authors.lastname: Shimamoto
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Kaneko
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Takahara
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Yaku
authors.forename: Kazuo
authors.initials: K
authors.lastname: Yamanaka
authors.forename: Akihiko
authors.initials: A
authors.lastname: Usui
authors.forename: Nobushige
authors.initials: N
authors.lastname: Tamura
authors.forename: Ryuzo
authors.initials: R
authors.lastname: Sakata
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000379:methods / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D011475:Prosthesis Failure; D012189:Retrospective Studies