title: Fifteen-year experience with the Bicarbon heart valve prosthesis in a single center.
abstract: BACKGROUND
  The purpose of this study was to evaluate retrospectively the clinical performance of the Bicarbon valve (Sorin Biomedica Cardio, Saluggia, Italy) implanted at our center in Japan.
  
  
  METHODS
  Between January 1997 and December 2011, 415 patients in our institution were implanted with the Bicarbon valve. Nine of these recipients were excluded from the study because they had already undergone valve implantation and received a Bicarbon valve in a different position. The remaining patients were analyzed for evaluation of the postoperative clinical outcomes. Of the 406 patients (mean age 60.2 ± 11.7 years), 179 underwent aortic valve replacement (AVR), 149 mitral valve replacement (MVR), and 78 both aortic and mitral valve replacement (DVR).
  
  
  RESULTS
  There were 10 early deaths (2.5 %: 4 in the AVR group and 6 in the MVR group). Three hundred eighty-nine patients were followed up (95.8 % completeness of follow-up) with a mean follow-up of 6.6 ± 4.2 years overall (AVR 6.8 ± 4.2, MVR, 6.7 ± 4.4, and DVR 5.7 ± 3.4 years) and a cumulative follow-up of 2661 patient-years (1214, 1001, and 446 patient-years for AVR, MVR, and DVR, respectively). Ninety-nine patients died (3.7 % per patient-year: 22 valve-related and 77 valve-unrelated deaths). Survival at 10 years was 74.1 ± 4.0 % in the AVR group, 73.7 ± 4.2 % in the MVR group, and 61.0 ± 7.9 % in the DVR group. The linearized incidence of thromboembolic complications, bleeding complications, prosthetic valve endocarditis, paravalvular leaks, and sudden death in all patients was 0.5 %, 0.5 %, 0.2 %, 0.2 %, and 0.4 % per patient-year, respectively. The incidence of valve-related complications and reoperation was 1.6 % and 0.4 %, respectively. No other valve-related complications were observed.
  
  
  CONCLUSIONS
  The Bicarbon prosthetic heart valve has shown excellent clinical results and is associated with a low incidence of valve-related complications.
authors.affiliation: Division of Cardiovascular Surgery, Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan. tcvmisa@jichi.ac.jp.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Misawa
authors.affiliation: Division of Cardiovascular Surgery, Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan. arata-m@jichi.ac.jp.
authors.forename: Arata
authors.initials: A
authors.lastname: Muraoka
authors.affiliation: Division of Cardiovascular Surgery, Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan. tcvohki@jichi.ac.jp.
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Ohki
authors.affiliation: Division of Cardiovascular Surgery, Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan. tcvai@jichi.ac.jp.
authors.forename: Kei
authors.initials: K
authors.lastname: Aizawa
authors.affiliation: Division of Cardiovascular Surgery, Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan. kj_kawahito@msn.com.
authors.forename: Koji
authors.initials: K
authors.lastname: Kawahito
authors.affiliation: Division of Cardiovascular Surgery, Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan. cvsricky@jichi.ac.jp.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Saito
authors.affiliation: Division of Cardiovascular Surgery, Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan. hirotakasato@jichi.ac.jp.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Sato
authors.affiliation: Division of Cardiovascular Surgery, Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan. ippei328@yahoo.co.jp.
authors.forename: Ippei
authors.initials: I
authors.lastname: Takazawa
authors.affiliation: Division of Cardiovascular Surgery, Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan. soki341@yahoo.co.jp.
authors.forename: Soki
authors.initials: S
authors.lastname: Kurumisawa
authors.affiliation: Division of Cardiovascular Surgery, Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan. no_fear_no_regret@yahoo.co.jp.
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Akutsu
authors.affiliation: Division of Cardiovascular Surgery, Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan. sugaya-tym@umin.net.
authors.forename: Akira
authors.initials: A
authors.lastname: Sugaya
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006349:Heart Valve Diseases / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult