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Bioprosthetic mitral valve replacement in patients aged 65 years or younger: long-term outcomes with the Carpentier-Edwards PERIMOUNT pericardial valve.
- Source :
-
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery [Eur J Cardiothorac Surg] 2018 Aug 01; Vol. 54 (2), pp. 302-309. - Publication Year :
- 2018
-
Abstract
- Objectives: Mitral valve replacement using a bioprosthesis remains controversial in young patients because data on long-term outcomes are missing. This study evaluated the long-term results of the PERIMOUNT pericardial mitral bioprosthesis in patients aged 65 years or younger.<br />Methods: From 1984 to 2010, 148 Carpentier-Edwards PERIMOUNT mitral bioprostheses were implanted in 148 patients aged 65 years or younger. Baseline clinical, perioperative and follow-up data were recorded prospectively. Structural valve deterioration (SVD) was defined by strict echocardiographic assessment.<br />Results: The mean follow-up period was 8.6 ± 5.5 years, for a total of 1269 valve-years. Operative mortality rate was 2.0%. Fifty-one late deaths occurred (linearized rate 4.0% per valve-year). Actuarial survival rates averaged 70 ± 4%, 53 ± 6% and 31 ± 7% after 10, 15 and 20 years of follow-up, respectively. Actuarial freedom from SVD at 10, 15 and 20 years was 78 ± 5%, 47 ± 7% and 19 ± 7%, respectively. Reoperation was associated with no operative mortality. Actuarial freedom from reoperation due to SVD at 10, 15 and 20 years was 82 ± 4%, 50 ± 6% and 25 ± 8%, respectively. Competing risk analysis demonstrated an actual risk of explantation secondary to SVD at 20 years of 44 ± 5%. Expected valve durability was 14.2 years for this age group.<br />Conclusions: In the selected patients aged 65 years or younger undergoing mitral valve replacement with a pericardial bioprosthesis, the expected valve durability was 14.2 years. Reoperation for SVD was associated with a low risk of mortality.
- Subjects :
- Adult
Aged
Humans
Kaplan-Meier Estimate
Middle Aged
Mitral Valve diagnostic imaging
Mitral Valve pathology
Postoperative Complications
Reoperation
Treatment Outcome
Young Adult
Bioprosthesis adverse effects
Bioprosthesis statistics & numerical data
Heart Valve Prosthesis adverse effects
Heart Valve Prosthesis statistics & numerical data
Heart Valve Prosthesis Implantation adverse effects
Heart Valve Prosthesis Implantation mortality
Heart Valve Prosthesis Implantation statistics & numerical data
Mitral Valve surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1873-734X
- Volume :
- 54
- Issue :
- 2
- 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 :
- 29444229
- Full Text :
- https://doi.org/10.1093/ejcts/ezy029