What are the long-term clinical outcomes and durability of the Carpentier-Edwards high profile porcine bioprosthesis in the mitral position in young adults with rheumatic disease?
The Carpentier-Edwards high profile bioprosthesis provides satisfactory clinical performance and survival in young adults with rheumatic disease, despite a high risk of structural degeneration by 12 years.
Carpentier-Edwards (C/E) high profile supra-annular porcine bioprostheses were implanted in 163 patients between September 1982-February 1987 in the mitral position due to rheumatic disease. The patients' ages ranged between 15 and 58 years (mean: 36.5 +/- 11.5). One hundred-two of the patients (62.5%) were female. The hospital mortality was 9.8% (16/163). The total cumulative follow-up period was 1093 patient-years (p-y) with a mean of 7.3 +/- 3.5 p-y (range 6 months-12 years). Linearised occurrence rates of the late complications were as follows: Thromboembolism 0.82%/p-v, anticoagulant-related bleeding 1.0%/p-y, prosthetic valve endocarditis 0.09%/p-y. Actuarial survival rates for 5 and 12 years were 87% +/- 6% and 76% +/- 9%, respectively, with 95% confidence limits. Freedom from structural deterioration was 92% +/- 5% for 5 years and 44% +/- 11% for 12 years. Freedom from all valve-related complications was 81% +/- 7 for 5 years and 26% +/- 9 for 12 years. In conclusion, this prosthesis provides satisfactory clinical performance in young population despite the high risk of degeneration with good prognosis and better tolerability of reoperation.
Yamak et al. (Sun,) studied this question.