CARPENTIER-EDWARDS PERICARDIAL VALVES IN THE MITRAL POSITION - 10-YEAR FOLLOW-UP

Objective: The first generation of pericardial valves was withdrawn fr om the market because of a high rate of premature failure, With an ori ginal design, Carpentier-Edwards pericardial valves promised improved results, Methods: One hundred fifty patients who underwent isolated mi tral valve replacement, between July 1984 and December 1993, with Carp entier-Edwards pericardial bioprostheses in our institution were follo wed up, Patient mean age was 62.9 +/- 11.9 years, Operative mortality was 3.3%, All but three patients were followed up for an average of 4. 7 years after operation, and total follow-up was 710 patient-years, Re sults: At the time this article was written, over 80% of patients were in New York Heart Association class I or II. After 10 years, actuaria l survival rate was 71% (confidence limit 61% to 81%), Valve-related c omplications included the following: six valve-related deaths (0.8% pa tient-year), five thromboembolic episodes (0.7% patient-year), three c ases of endocarditis (0.4% patient-year), four reoperations (0.5% pati ent-year), and four structural valve failures with calcification and s tenosis (0.5% patient-year), After 10 years, freedom from valve-relate d complications was 66% (confidence limit 46% to 86%), from valve-rela ted death 94% (confidence limit 89% to 99%), from reoperation 90% (con fidence limit 82% to 98%), and from valve failure 76% (confidence limi t 62% to 90%), Conclusions: With a low rate of valve-related events at 10 years and a low rate of structural deterioration with no leaflet t ear, this prosthesis is a reliable choice for patients over 60 years o f age.