BACKGROUND: Pericardial bioprostheses have favorable echocardiographic hemodynamics in the aortic position compared with porcine valves; however, there are few data comparing clinical outcomes. Our objective was to assess the late results of the two valve types. METHODS: We reviewed 2,979 patients aged 65 years or older undergoing aortic valve replacement with pericardial (n=1,976) or porcine (n=1,003) prostheses between January 1993 and December 2007. The most common pericardial prostheses were Carpentier-Edwards Perimount and Mitroflow, and the most common porcine valves were Medtronic Mosaic, Carpentier-Edwards, Hancock modified orifice, and St. Jude Biocor. Follow-up extended to a maximum of 16 years (mean, 5.2±3.5 years). RESULTS: Survival at 5, 10 and 12 years was, respectively, 68%, 33%, and 21% overall, was 68%, 30%, and 16% for patients with pericardial bioprosthesis, and was 69%, 38% and 27% for the porcine group. In a multivariate model, long-term survival was reduced in patients with diabetes, renal failure, prior myocardial infarction, congestive heart failure, and older age, but late survival was not higher in the pericardial valve group. Overall freedom from reoperation was 96%, 92%, and 90% at 5, 10, and 12 years, and freedom from explant was 98%, 96%, and 94% during the same period. The reason for explant was structural valve deterioration in 50 patients (2%). CONCLUSIONS: Despite the better hemodynamic performance documented in prior investigations, pericardial valves do not confer any survival advantage over porcine valves in patients aged 65 years or older undergoing aortic valve replacement.
BACKGROUND: Pericardial bioprostheses have favorable echocardiographic hemodynamics in the aortic position compared with porcine valves; however, there are few data comparing clinical outcomes. Our objective was to assess the late results of the two valve types. METHODS: We reviewed 2,979 patients aged 65 years or older undergoing aortic valve replacement with pericardial (n=1,976) or porcine (n=1,003) prostheses between January 1993 and December 2007. The most common pericardial prostheses were Carpentier-Edwards Perimount and Mitroflow, and the most common porcine valves were Medtronic Mosaic, Carpentier-Edwards, Hancock modified orifice, and St. Jude Biocor. Follow-up extended to a maximum of 16 years (mean, 5.2±3.5 years). RESULTS: Survival at 5, 10 and 12 years was, respectively, 68%, 33%, and 21% overall, was 68%, 30%, and 16% for patients with pericardial bioprosthesis, and was 69%, 38% and 27% for the porcine group. In a multivariate model, long-term survival was reduced in patients with diabetes, renal failure, prior myocardial infarction, congestive heart failure, and older age, but late survival was not higher in the pericardial valve group. Overall freedom from reoperation was 96%, 92%, and 90% at 5, 10, and 12 years, and freedom from explant was 98%, 96%, and 94% during the same period. The reason for explant was structural valve deterioration in 50 patients (2%). CONCLUSIONS: Despite the better hemodynamic performance documented in prior investigations, pericardial valves do not confer any survival advantage over porcine valves in patients aged 65 years or older undergoing aortic valve replacement.
Authors: Martin Andreas; Stephanie Wallner; Kurt Ruetzler; Dominik Wiedemann; Marek Ehrlich; Georg Heinze; Thomas Binder; Anton Moritz; Michael J Hiesmayr; Alfred Kocher; Guenther Laufer Journal: Eur J Cardiothorac Surg Date: 2014-12-18 Impact factor: 4.191
Authors: Jongbae Son; Yang Hyun Cho; Dong Seop Jeong; Kiick Sung; Wook Sung Kim; Young Tak Lee; Pyo Won Park Journal: Korean J Thorac Cardiovasc Surg Date: 2018-04-05
Authors: Simone A Huygens; Mostafa M Mokhles; Milad Hanif; Jos A Bekkers; Ad J J C Bogers; Maureen P M H Rutten-van Mölken; Johanna J M Takkenberg Journal: Eur J Cardiothorac Surg Date: 2016-03-29 Impact factor: 4.191
Authors: Hong Ju Shin; Wan Kee Kim; Jin Kyoung Kim; Joon Bum Kim; Sung-Ho Jung; Suk Jung Choo; Cheol Hyun Chung; Jae Won Lee Journal: Korean Circ J Date: 2021-12-07 Impact factor: 3.243