Carpentier-Edwards Pericardial Valve in the Aortic Position: 25-Years Experience

Background. The Carpentier-Edwards pericardial valve was designed to minimize structural valve deterioration. Excellent durability and low incidence of valve-related complications have been reported. The objective of the present study was to analyze clinical results after 25 years of experience with this valve implanted in the aortic position. The effect of patient age at the time of surgery was also evaluated. Methods. This is a retrospective cohort study of 2,405 patients from November 1981 to March 2011. Primary outcomes of interest were survival and freedom from major adverse effects such as thromboembolic, endocarditis, and reoperation. Results. Sixty percent were male, with a mean age of 71 +/- 9 years old. Actuarial survival rates including early deaths averaged 78% +/- 2%, 55% +/- 2%, and 16 % +/- 2% after 5, 10, and 20 years of follow-up, respectively. The freedom rate of valve reoperation for prosthesis dysfunction and all other causes averaged 98 % +/- 0.2%, 96% +/- 1%, and 67% +/- 4% at 5, 10, and 20 years. Patients younger than 60 years of age had a 15-year survival averaging 54% +/- 5% compared with patients aged between 60 and 70 years of age averaging 46% +/- 3% and with patients older than 70 years of age averaging 28% +/- 3% (p = 0.001). Survival at 5, 10, and 20 years for patients who had concomitant CABG [coronary artery bypass grafting] were 78% +/- 1%, 55% +/- 2%, and 9% +/- 3% compared with no concomitant CABG (84% +/- 1%, 62% +/- 2%, and 22% +/- 3% (p < 0.001)). Conclusions. Carpentier-Edwards pericardial valve implantation in the aortic position is secure and durable. The effects of age influence reoperation rate and survival as well as a concomitant coronary artery bypass procedure. (C) 2013 by The Society of Thoracic Surgeons