You, Ji Hoon; Jeong, Dong Seop; Sung, Kiick; Kim, Wook Sung; Carriere, K C; Lee, Young Tak; Park, Pyo Won
The Annals of thoracic surgery
2016Jun ; 101 ( 6 ) :2209-16.
PMID : 26872735
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You, Ji Hoon -
Jeong, Dong Seop -
Sung, Kiick -
Kim, Wook Sung -
Carriere, K C -
Lee, Young Tak -
Park, Pyo Won -
ABSTRACT
BACKGROUND: To compare hemodynamic performance and clinical outcomes after aortic valve replacement for aortic stenosis with the 19-mm Carpentier-Edwards pericardial bioprosthesis versus larger valves.
METHODS: Between January 1998 and December 2013, 447 consecutive patients underwent aortic valve replacement for aortic stenosis with the Carpentier-Edwards Perimount (n?= 61) or Magna bioprostheses (n?= 386). Based on the implanted valve size, the patients were classified into three groups: a 19-mm group (n?= 54), a 21-mm group (n?= 154), and a 23-mm to 27-mm group (n?= 239). The in?vivo effective orifice area index was measured by transthoracic echocardiography 12 months after operation (n?= 331). The mean follow-up time was 4.9 ± 3.5 (maximum 15.4) years.
RESULTS: There were three early deaths (0.7%). At 10 years, overall survival (84.1%) was unaffected by patient-prosthesis mismatch (18.7%, 62 patients), and freedom from structural valve deterioration and endocarditis was 100% and 97.1%, respectively. Although the 19-mm group was significantly older and had a higher incidence of patient-prosthesis mismatch (n?= 14, 30.4%), there were no significant differences in early outcomes, overall survival, cardiac-related mortality, or serial reduction of left ventricular mass index in comparison with patients with a larger bioprostheses. Independent risk factors for all-cause mortality were age, male gender, combined coronary artery bypass graft, and low hemoglobin level. CONCLUSION: The Carpentier-Edwards pericardial bioprosthesis appears to be associated with acceptable clinical outcomes and hemodynamic profile. CI - Copyright ??2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
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