INFLUENCE OF AGE ON VALVE RELATED EVENTS WITH CARPENTIER-EDWARDS PERICARDIAL BIOPROSTHESIS

Age is the most important factor for the durability of biological valv es. With an original design the Carpentier-Edwards pericardial valve s howed improved results at 10 years. The influence of age on valve rela ted complications is studied with a 10 year follow up on 807 valvular replacements. Methods: Between January 1984 and December 1993, 807 pat ients underwent Valve replacements with a Carpentier-Edwards pericardi al bioprosthesis. Patients, 193 were younger than 60 years, 284 betwee n 60 and 70 years and 330 patients were older than 70 years. All patie nts but seven were followed up for an average of 4.18 years after thei r operation and total follow up was 3373 patient years. Patients were divided into three groups of age: group I, less than 60 years; group I I, 60-70 years; group III, over 70 years. A retrospective comparison w as made between age groups. Results: At 11 years, valve related compli cations included 97 patients with 27 valve related deaths. Rates of va lve related death increase with age linearized rate were 0.3, 0.6 and 1.2%, respectively. No difference was observed for rates of all valve related morbidity: 2.6, 2.4 and 3.5%, respectively. Risk of thromboemb olism increased with age, linearized rates were: 0.3, 0.7 and 1.3%. Ri sk of deterioration and reoperation decreased with age, rates of deter ioration were 0.8, 0.1 and 0%. Other valve related events had the same incidence in all groups. No statistical difference was observed betwe en group II and group III for deteriorations and reoperations. Conclus ions: The performance of the Carpentier-Edwards pericardial valve is t he same at 10 years in group II and III. This study supports the clini cal use of this tissue valve in patients over 60 years. The results in group I are satisfactory,nevertheless, a more durable biological valv e is needed for young patients. (C) 1997 Elsevier Science B.V.