12-YEAR EXPERIENCE WITH CARPENTIER-EDWARDS PERIMOUNT PERICARDIAL VALVE IN THE MITRAL POSITION - A MULTICENTER STUDY

Background and aims of the study: The study aim was to assess the dura bility of the Carpentier-Edwards PERIMOUNT pericardial bioprosthesis i n the mitral position. Methods: This seven-center retrospective clinic al study involved the follow up of 333 patients who underwent isolated mitral valve replacement and 102 patients who underwent double (mitra l and aortic) valve replacement with the PERIMOUNT pericardial valve b etween 1984 and 1989. Mean patient age at implant was 60.7 +/- 11.6 ye ars; 41.1% were males. The most common etiology was rheumatic heart di sease (53.9%) and the most common mechanism mitral insufficiency. All patients but six were followed for an average of 7.2 +/- 3.6 years aft er surgery; total follow up was 3071.7 patient-years (pt-yr). Results: The total operative mortality rate was 7.6%; this included a valve-re lated mortality rate of 0.2%. The late mortality rate was 5.2% per pt- yr, of which 1.4% per pt-yr was considered valve-related. At 11 years, the overall actuarial survival rate was 53.3 +/- 2.8%, and actuarial freedom from valve-related death 83.9 +/- 2.6%. At follow up, 80% of p atients were in NYHA class I or II, and 74% showed improvement. Twenty -eight incidences of deterioration requiring explant were observed. At 11 years the actuarial freedom from explant due to structural failure was 84.9 +/- 3.1%. Rates of structural failure decreased with age: th e actuarial freedom from explant due to structural failure was 78.1 +/ - 4.8% for patients aged less than or equal to 60 years, 89.4 +/- 4.4% for those aged 61-70 years, and 100% for those aged over 71 years. Co nclusion: The Carpentier-Edwards PERIMOUNT pericardial bioprosthesis i s a reliable choice when a tissue valve is required, especially in pat ients over 60 years of age.