MITRAL-VALVE REPLACEMENT WITH THE CARPENTIER-EDWARDS STANDARD BIOPROSTHESIS - PERFORMANCE INTO THE 2ND DECADE

From March 1978, 196 Carpentier-Edwards standard bioprostheses (stCE) were implanted in 194 patients. There were 154 isolated mitral valve r eplacements (MVR) and 42 aortic plus mitral valve replacements (AVR/MV R) with a mean follow-up of 7.05 (range 0-15.2) years and 7.15 (range 0-13.8) years, respectively. Freedom from structural valve failure at 10 years was 70.8% +/- 4.9% (MVR) and 59.6% +/- 11.1% (AVR/MVR), The i ncidence of structural valve failure increased sharply after 7 years. Freedom from thromboembolism was 83.0% +/- 3.8% (MVR) and 89.0 +/- 6.0 % (AVR/MVR). Thromboembolic events were related to the presence of atr ial fibrillation in patients not receiving anticoagulation. Anticoagul ant-related haemorrhage was rare. Freedom from mitral valve prosthetic endocarditis at 10 years was 90.9% +/- 3.1% (MVR) and 86.1% +/- 8.4% (AVR/MVR). Prosthetic valve endocarditis was associated with more than 60% mortality. The probability of event-free survival at 10 years fol low-up was 43.6% +/- 4.6% (MVR) and 33.3% +/- 8.6% (AVR/MVR). The perf ormance of the stCE in the mitral position shows a low rate of thrombo embolic events and anticoagulant-related haemorrhage, but the longterm performance of the prosthesis is unsatisfactory due to a high rate of structural valve failure. This confirms earlier reports.