| Comparison of Carpentier-Edwards pericardial and supraannular bioprostheses in aortic valve replacement. | |
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MedLine Citation:
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PMID: 16386920 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Comparative Study; Journal Article; Meta-Analysis; Review Date: 2006-01-18 |
Journal Detail:
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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:
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Created Date: 2006-02-13 Completed Date: 2006-04-13 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8804069 Medline TA: Eur J Cardiothorac Surg Country: Germany |
Other Details:
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Languages: eng Pagination: 374-9 Citation Subset: IM |
Affiliation:
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Department of Cardio-thoracic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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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