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Ann Thorac Surg 2002;74:2010-2015
© 2002 The Society of Thoracic Surgeons
a Department of Echocardiography, Hôpital Cardiologique, Centre Hospitalier Régional et Universitaire de Lille, 59037 Lille Cedex, France
b Department of Cardiac Surgery, Hôpital Cardiologique, Centre Hôpitalier Régional et Universitaire de Lille, Lille, France
Accepted for publication July 12, 2002.
* Address reprint requests to Dr Le Tourneau, Department of Echocardiography, Hôpital Cardiologique, Boulevard du Professeur J. Leclerc, 59037 Lille Cedex, France.
e-mail: thletourneau{at}yahoo.fr
BACKGROUND: There are little comparative data on Carpentier-Edwards supraannular and pericardial second-generation bioprostheses. The aim of this work was to compare their hemodynamic and clinical outcomes in patients with aortic stenosis.
METHODS: We conducted a retrospective study including 150 patients operated on for aortic stenosis between 1989 and 1993. Patients undergoing aortic valve replacement with either a Carpentier-Edwards supraannular or pericardial prosthesis were matched for sex (49% male), age (72 ± 8 years), body surface area, valve size, associated procedures, and left ventricular ejection fraction.
RESULTS: Mean follow-up was 6.5 ± 3.3 years, giving a total follow-up of 983 patient-years. Thirty-day mortality and 10-year actuarial survival were, respectively, 8% and 51% in the supraannular group and 6.7% and 43.4% in the pericardial group. At 10 years, freedom from thromboembolism, structural failure, and all valve-related events were, respectively, 88.7%, 88.9%, and 68.7% in the supraannular group and 85%, 100%, and 82.2% in the pericardial group. There were four (5.3%) structural failures, and four (5.3%) reoperations for degeneration (n = 3) and endocarditis (n = 1) in the supraannular group. Freedom from structural dysfunction or reoperation was 87.3% in the supraannular group and 100% (p < 0.05) in the pericardial group. Echocardiographic review of 62 of 76 survivors (81.5%) demonstrated a trend toward a better hemodynamic profile of pericardial valves at the end of follow-up.
CONCLUSIONS: Ten years after aortic valve replacement for aortic stenosis, Carpentier-Edwards pericardial prostheses give comparable and probably better results than Carpentier-Edwards supraannular prostheses.
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