Document Detail


Comparison of Carpentier-Edwards pericardial and supraannular bioprostheses in aortic valve replacement.
MedLine Citation:
PMID:  16386920     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: This study aimed at calculating and comparing the long-term outcomes of patients after aortic valve replacement with the Carpentier-Edwards bovine pericardial and porcine supraannular bioprostheses using microsimulation. METHODS: We conducted a meta-analysis of eight studies on the Carpentier-Edwards pericardial valves (2,685 patients, 12,250 patient-years) and five studies on the supraannular valves (3,796 patients, 20,127 patient-years) to estimate the occurrence rates of valve-related events. Eighteen-year follow-up data sets were used to construct age-dependent Weibull curves that described their structural valvular deterioration. The estimates were entered into a microsimulation model, which was used to calculate the outcomes of patients after aortic valve replacement. RESULTS: The annual hazard rates for thrombo-embolism after aortic valve replacement were 1.35% and 1.76% for the pericardial and supraannular valves, respectively. For a 65-year-old male, median time to structural valvular deterioration was 20.1 and 22.2 years while the lifetime risk of reoperation due to structural valvular deterioration was 18.3% and 14.0%, respectively. The life expectancy of the patient was 10.8 and 10.9 years and event-free life expectancy 9.0 and 8.8 years, respectively. CONCLUSIONS: The microsimulation methodology provides insight into the prognosis of a patient after aortic valve replacement with any given valve type. Both the Carpentier-Edwards pericardial and supraannular valve types perform satisfactorily, especially in elderly patients, and show no appreciable difference in long-term outcomes when implanted in the aortic position.
Authors:
John P A Puvimanasinghe; Johanna J M Takkenberg; Marinus J C Eijkemans; Lex A van Herwerden; W R Eric Jamieson; Gary L Grunkemeier; J Dik F Habbema; Ad J J C Bogers
Publication Detail:
Type:  Comparative Study; Journal Article; Meta-Analysis; Review     Date:  2006-01-18
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  29     ISSN:  1010-7940     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-02-13     Completed Date:  2006-04-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  374-9     Citation Subset:  IM    
Affiliation:
Department of Cardio-thoracic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Aged
Animals
Aortic Valve / surgery*
Bioprosthesis* / adverse effects
Cattle
Female
Heart Valve Prosthesis* / adverse effects
Heart Valve Prosthesis Implantation* / adverse effects
Humans
Male
Middle Aged
Prognosis
Swine
Thromboembolism / etiology
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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