TY - JOUR
T1 - Durability of pericardial versus porcine aortic valves
AU - Gao, Guangqiang
AU - Wu, Ying Xing
AU - Grunkemeier, Gary L.
AU - Furnary, Anthony P.
AU - Starr, Albert
N1 - Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2004/7/21
Y1 - 2004/7/21
N2 - Objectives This study compares the long-term performance of the Carpentier-Edwards (CE) porcine bioprosthesis and the CE pericardial bioprosthesis for aortic valve replacement (AVR). Background With new bioprostheses on the horizon, there is renewed interest in how the long-term durability of current pericardial bioprostheses compares with the traditional porcine bioprosthesis. Methods We reviewed 518 AVR with CE porcine valves from 1974 to 1996 and 1,021 AVR with CE pericardial valves from 1991 to 2002. The age distribution and clinical profiles were similar for both groups. The total (mean) follow-up was 3,322 (6.4) years for porcine and 2,556 (2.5) years for pericardial. Results Long-term mortality was similar (p = 0.29) for porcine and pericardial, with 10-year survival rates of 34 ± 2% and 38 ± 6%, respectively. Ten-year freedom from major adverse cardiac events was also similar for both (respectively): thromboembolism (80 ± 2% and 87 ± 2%; p = 0.24); endocarditis (98 ± 1% and 99 ± 1%; p = 0.30). However, 10-year freedom from explant was lower for porcine (90 ± 2%) than for pericardial (97 ± 1%, p = 0.04). Reasons for explant for porcine were structural valve deterioration (SVD) (n = 25), endocarditis (n = 4), and periprosthetic leak (n = 2). The reasons for explant for pericardial were SVD (n = 4), endocarditis (n = 4) and periprosthetic leak (n = 1). Conclusions The current CE pericardial valve offers better midterm durability than the traditional CE porcine valve. Its freedom from SVD and reoperation makes it our current bioprosthesis of choice for AVR in appropriately selected patients.
AB - Objectives This study compares the long-term performance of the Carpentier-Edwards (CE) porcine bioprosthesis and the CE pericardial bioprosthesis for aortic valve replacement (AVR). Background With new bioprostheses on the horizon, there is renewed interest in how the long-term durability of current pericardial bioprostheses compares with the traditional porcine bioprosthesis. Methods We reviewed 518 AVR with CE porcine valves from 1974 to 1996 and 1,021 AVR with CE pericardial valves from 1991 to 2002. The age distribution and clinical profiles were similar for both groups. The total (mean) follow-up was 3,322 (6.4) years for porcine and 2,556 (2.5) years for pericardial. Results Long-term mortality was similar (p = 0.29) for porcine and pericardial, with 10-year survival rates of 34 ± 2% and 38 ± 6%, respectively. Ten-year freedom from major adverse cardiac events was also similar for both (respectively): thromboembolism (80 ± 2% and 87 ± 2%; p = 0.24); endocarditis (98 ± 1% and 99 ± 1%; p = 0.30). However, 10-year freedom from explant was lower for porcine (90 ± 2%) than for pericardial (97 ± 1%, p = 0.04). Reasons for explant for porcine were structural valve deterioration (SVD) (n = 25), endocarditis (n = 4), and periprosthetic leak (n = 2). The reasons for explant for pericardial were SVD (n = 4), endocarditis (n = 4) and periprosthetic leak (n = 1). Conclusions The current CE pericardial valve offers better midterm durability than the traditional CE porcine valve. Its freedom from SVD and reoperation makes it our current bioprosthesis of choice for AVR in appropriately selected patients.
KW - AVR
KW - CE
KW - Carpentier-Edwards
KW - FDA
KW - Food and Drug Administration
KW - KM
KW - Kaplan-Meier
KW - SVD
KW - aortic valve replacement
KW - structural valve deterioration
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U2 - 10.1016/j.jacc.2004.01.053
DO - 10.1016/j.jacc.2004.01.053
M3 - Article
C2 - 15261935
AN - SCOPUS:3242685283
VL - 44
SP - 384
EP - 388
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
SN - 0735-1097
IS - 2
ER -