Document Detail


Long-term clinical and hemodynamic performance of the Hancock II versus the Perimount aortic bioprostheses.
MedLine Citation:
PMID:  20837899     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The Medtronic Hancock II and the Carpentier-Edwards Perimount are among the world's most commonly used aortic bioprostheses. However, a direct comparison of their clinical performance is lacking. To minimize biases inherent to between-center comparisons, we examined these prostheses within a large, contemporary, single-center cohort. METHODS AND RESULTS: Between 1990 and 2007, 1659 patients (mean age, 73.1±9.3 years) underwent aortic valve replacement with either the Hancock II (N=1021) or the Perimount (N=638). Patients were prospectively followed-up with serial clinic visits and echocardiograms for up to 16 years (mean, 5.0±3.3 years). There was no significant difference in aortic root size preoperatively (P=0.7). Aortic root enlargement was more commonly performed with the Perimount (P<0.001), and the manufacturer valve size of the implanted prosthesis was larger with the Hancock II (P<0.001). Postoperatively, peak and mean transprosthesis gradients were higher for the Hancock II (32.7±0.7 and 16.0±0.3 mm Hg, respectively) than for the Perimount (24.9±0.7 and 13.4±0.4 mm Hg, respectively; P<0.001). However, no difference in left ventricular mass regression was observed at late follow-up (P=0.9). Unadjusted 10-year survival was 59.4%±2.4% for the Hancock II and 70.2%±3.8% for the Perimount (P=0.07). Multivariable predictors of survival did not include prosthesis type (P=0.2). CONCLUSIONS: For the same manufacturer valve size, the Perimount is larger, which may warrant enlarging the aortic root more often, and it is associated with better hemodynamics than the Hancock II. These differences do not impact survival or left ventricular mass regression, and the long-term clinical performances of the Hancock II and Perimount bioprostheses are equivalent.
Authors:
Vincent Chan; Alexander Kulik; Anthony Tran; Paul Hendry; Roy Masters; Thierry G Mesana; Marc Ruel
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation     Volume:  122     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-14     Completed Date:  2010-10-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S10-6     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiac Surgery, University of Ottawa, Ottawa, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Aorta / physiopathology*
Aortic Diseases / mortality,  physiopathology*,  surgery*
Bioprosthesis*
Disease-Free Survival
Echocardiography
Female
Follow-Up Studies
Hemodynamics
Humans
Male
Middle Aged
Retrospective Studies
Survival Rate

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


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