Original articleAdult cardiacCarpentier-Edwards Pericardial Valve in the Aortic Position: 25-Years Experience
Section snippets
Patients and Methods
This retrospective cohort study reviewed 2,405 patients who underwent aortic valve replacement (AVR) with CE pericardial valves from November 1981 to March 2011. Patients with associated procedures such as aortoplasty and coronary artery bypass grafts (CABG) were included in this cohort. Patients who underwent repair or replacement of another valve concomitantly or a Bentall procedure were excluded from the present analysis (23%).
Data were prospectively recorded. Patients were followed at the
Survival and Functional Status
One hundred seventeen (117 of 2,405, 4.9%) patients died during the first 30 days after surgery. Cardiac failure and noncardiac problems were the main causes of early death. Postoperative complications included bleeding and tamponade and atrioventricular block as the 2 most frequent events (Table 2). Percentage of late death was 28% and total death including early deaths at 30 years was 33%. Causes of death were principally unknown (40%) followed by cardiac insufficiency (21%) and myocardial
Comment
The present study showed that the freedom rate from reoperation for structural valve deterioration (SVD) averaged 99% in patients older than 70 years of age at implantation throughout the 30-year period of the study. Rates of reoperation increased significantly in the younger groups of patients. Moreover, prosthetic valve endocarditis remains the first cause of valve reoperation in elderly patients and the second cause after SVD in younger patients.
Studies examining the experience with the CE
References (17)
Choice of prosthetic heart valve in adults an update
J Am Coll Cardiol
(2010)- et al.
2008 focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease). Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons
J Am Coll Cardiol
(2008) - et al.
Pericardial heterografts: why do these valves fail?
J Thorac Cardiovasc Surg
(1988) - et al.
Late outcomes for aortic valve replacement with the Carpentier-Edwards pericardial bioprosthesis: up to 17-year follow-up in 1,000 patients
Ann Thorac Surg
(2010) - et al.
Carpentier-Edwards pericardial bioprosthesis in aortic or mitral position: A 12-year experience
Ann Thorac Surg
(1998) - et al.
Guidelines for reporting morbidity and mortality after cardiac valvular operations. Ad hoc Liaison Committee for Standardizing Definitions of Prosthetic Heart Valve Morbidity of The American Association for Thoracic Surgery and The Society of Thoracic Surgeons
J Thorac Cardiovasc Surg
(1996) - et al.
Operative risk of reoperative aortic valve replacement
J Thorac Cardiovasc Surg
(2005) - et al.
Outcomes of reoperative aortic valve replacement after previous sternotomy
J Thorac Cardiovasc Surg
(2010)