Long-term results of the Carpentier-Edwards pericardial aortic valve: A 12-year follow-up

Background. Pericardial valves have excellent hemodynamic function; however , long-term durability is questionable. To determine the function of the Ca rpentier-Edwards pericardial valve in the aortic position, the results of 3 10 aortic valve replacements performed between 1982 and 1985 were analyzed. Mean age was 64.2 +/- 10.8 years (range, 22 to 95 years); 190 (61.3%) were men. Isolated valve replacement was performed in 135 patients (43.5%). The re were 18 hospital deaths (5.8%), none of them valve related. Methods. Follow-up of 292 survivors was 100% complete at a mean of 8.8 year s; 2,556 patient-years of follow-up were analyzed. There were 150 late deat hs (51.4%). Survival at 5, 10, and 12 years were 83% +/- 2%, 47% +/- 3%, an d 34% +/- 3%, respectively. The 12-year actuarial and actual freedom from t hromboembolism was 87% +/- 2% and 89% +/- 2%, respectively. Freedom from he morrhage was 91% +/- 2% and 92% +/- 2%; freedom from endocarditis was 93% /- 2% and 95% +/- 1%; and freedom from structural deterioration was 82% +/- 4% and 91% +/- 2%, respectively. Results. Actuarial freedom from structural deterioration at 12 years was co nsiderably higher for 153 hospital survivors 65 years or older, 93% (5 expl ants) compared to 76% (19 explants) for patients younger than 65 years, p = 0.03. Of 24 explanted valves for structural deterioration, leaflet calcifi cation resulting in stenosis occurred in 20 (83%) and 4 were wear-related l eaflet tears. Conclusions. We conclude that the Carpentier-Edwards pericardial valve has a low incidence of valve-related complications, that structural deteriorati on is infrequent and results from leaflet calcification, and that the low i ncidence of structural deterioration in patients 65 years or older makes th is an increasingly appropriate option in this age group. (C) 1998 by The So ciety of Thoracic Surgeons.