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The Stentless Cryo-Life O'Brien porcine aortic valve at 10 years.
- Source :
-
The Journal of heart valve disease [J Heart Valve Dis] 2004 Nov; Vol. 13 (6), pp. 977-83; discussion 983. - Publication Year :
- 2004
-
Abstract
- Background and Aim of the Study: If stentless devices--with their physiological advantages--are to remain attractive, their long-term durability must equate with that of reference stented valves.<br />Methods: Between August 1991 and August 2001, 650 patients (mean age 72.0+/-4.2 years) received a Cryo-Life O'Brien Stentless aortic porcine bioprosthesis. The mean follow up was 4.6 years; total follow up was 2,644 patient-years (pt-yr). Among patients, 79% were in NYHA classes III-IV. Calcific aortic stenosis accounted for 93% of patients, who were predominantly female (75%), with associated coronary surgery in 19% and mitral surgery in 10.3%. Follow up was based on serial echocardiography, referring cardiologists' reports, and direct home telephone calls. Data were gathered over a six-month period.<br />Results: Operative mortality was 8.1% (n = 51). Of these deaths, 2.7% were in isolated cases (mean age 72.0+/-4.2 years) and 14% with associated procedures (mean age 77.0+/-5.3 years). There were 103 late deaths (3.9% per pt-yr). Valve-related complications included 14 deaths (linearized rate 0.52% per pt-yr), reoperation in 22 (0.8% per pt-yr), eight operated valvular endocarditis (0.3% per pt-yr), two valve thrombosis (0.07% per pt-yr), 11 embolic events (0.3% per pt-yr), and 14 anticoagulant-related bleeding (0.52% per pt-yr). Actuarial survival was 76+/-6% at 10 years, with a freedom from structural deterioration of 99.75% in patients aged > or =65 years (mean age 76+/-8 years), and 86% in patients aged <65 years (mean age 44+/-15 years). The gradients remained low, and the echocardiographic aspect was close to that of a normal valve.<br />Conclusion: At 10 years, the Cryo-Life O'Brien Stentless provided excellent results in terms of durability associated with all the stentless advantages relating to physiology--gradients, orifice areas, and mass regression--that translate into an appropriately adapted left ventricular exertion profile.
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Aortic Valve Insufficiency mortality
Aortic Valve Insufficiency physiopathology
Aortic Valve Insufficiency surgery
Aortic Valve Stenosis mortality
Aortic Valve Stenosis physiopathology
Female
Follow-Up Studies
Hemodynamics
Humans
Male
Middle Aged
Prosthesis Failure
Reoperation
Survival Analysis
Treatment Outcome
Aortic Valve Stenosis surgery
Bioprosthesis
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation adverse effects
Stents
Subjects
Details
- Language :
- English
- ISSN :
- 0966-8519
- Volume :
- 13
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- The Journal of heart valve disease
- Publication Type :
- Academic Journal
- Accession number :
- 15597593