The Carpentier-Edwards bioprosthesis: a comparative study analyzing failure rates by age

Bioprosthetic valve durability and the significance of patient age at implantation have received much attention recently. Indications and/or contraindications for implantation of the bioprosthesis in the very young and in the elderly have been reasonably well defined. Patients in the middle years (s...

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Bibliographic Details
Published inJournal of cardiac surgery Vol. 3; no. 3 Suppl; p. 369
Main Authors Pupello, D F, Bessone, L N, Hiro, S P, Lopez-Cuenca, E, Glatterer, Jr, M S, Ebra, G
Format Journal Article
LanguageEnglish
Published United States 01.09.1988
Subjects
Age Factors
Aged
Aged, 80 and over
Bioprosthesis - standards
Female
Florida - epidemiology
Follow-Up Studies
Heart Valve Diseases - classification
Heart Valve Diseases - mortality
Heart Valve Diseases - surgery
Heart Valve Prosthesis - adverse effects
Heart Valve Prosthesis - mortality
Heart Valve Prosthesis - standards
Humans
Male
Middle Aged
Prosthesis Failure
Survival Analysis
Survival Rate
Florida
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Summary:Bioprosthetic valve durability and the significance of patient age at implantation have received much attention recently. Indications and/or contraindications for implantation of the bioprosthesis in the very young and in the elderly have been reasonably well defined. Patients in the middle years (sixth and seventh decades) present a special problem in the choice of a prosthesis. To better elucidate the failure rate of the Carpentier-Edwards bioprosthesis in middle-aged patients, a comparative study of value failure rates was conducted using the Wilcoxon (Breslow) statistical technique. From September 1978 to December 1986, 502 patients underwent valve replacement with a Carpentier-Edwards bioprosthesis. All patients were operated on by a single surgical team using precisely the same method of valve implantation and myocardial preservation. The overall 30-day mortality was 8.4%. PATIENT SURVIVAL: Follow-up was obtained on all 460 hospital survivors and extends to 109.2 months with a mean of 36.8 months. The cumulative survival is 1,410.6 patient-years. VALVE SURVIVAL: The 481 patients that left the hospital were divided into two subgroups. Group I included patients aged 55 to 69 years; group II, 70 years and older. There were 8 valve failures in group I. The percent of valves free of failure plotted by the actuarial method is 95.4% at 5 years (SEM 1.7, 81 valves at risk) and 95% at 7 years (SEM 1.7, 23 valves at risk). In group II (age 70 and above), there were only two valve failures.
ISSN:0886-0440
DOI:10.1111/jocs.1988.3.3s.369