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Very long-term outcomes of the Carpentier-Edwards Perimount aortic valve in patients aged 50-65 years.
- Source :
-
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery [Eur J Cardiothorac Surg] 2016 May; Vol. 49 (5), pp. 1462-8. Date of Electronic Publication: 2015 Nov 02. - Publication Year :
- 2016
-
Abstract
- Objectives: Aortic valve replacement (AVR) using a bioprosthesis remains controversial for patients aged 50-65 years. This cohort study reports the very long-term outcomes of AVR using Carpentier-Edwards Perimount pericardial bioprosthesis in this age group.<br />Methods: From 1984 to 2008, 522 Carpentier-Edwards Perimount pericardial aortic bioprostheses were implanted in 516 patients aged 50-65 years (mean age, 60 ± 4 years; 19% female). Multiple valve replacements were excluded fro m our cohort. Baseline demographic, perioperative and follow-up data were recorded prospectively. Mean follow-up was 9 ± 6 years, for a total of 4428 valve-years. Follow-up was complete for 97% of patients included.<br />Results: Operative mortality rate was 2%. One hundred and forty-six late deaths occurred for a linearized rate of 3%/valve-year. Actuarial survival rates averaged 73 ± 2, 59 ± 3 and 35 ± 5% after 10, 15 and 20 years of follow-up, respectively. Mortality rate associated with reoperation was 2%. Actuarial freedom from reoperation rates due to structural valve deterioration (SVD) at 10, 15 and 20 years was respectively of 91 ± 2, 76 ± 3 and 50 ± 6%. Competing risk analysis demonstrated an actual risk of explantation secondary to SVD at 20 years of 30 ± 3%. Expected valve durability was 19 years for this age group. Age was not a significant risk factor for SVD in this middle-aged population.<br />Conclusions: In patients aged 50-65 years undergoing AVR with the Carpentier-Edwards Perimount bioprosthesis, the expected valve durability was 19 years. Age was not a significant risk factor for SVD within this age group. Patient selection and attention to timing of reintervention may be determinants of long-term outcomes.<br /> (© The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
- Subjects :
- Aged
Female
Heart Valve Diseases surgery
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Retrospective Studies
Aortic Valve surgery
Bioprosthesis
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation adverse effects
Heart Valve Prosthesis Implantation instrumentation
Heart Valve Prosthesis Implantation mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1873-734X
- Volume :
- 49
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 26530269
- Full Text :
- https://doi.org/10.1093/ejcts/ezv384