| Perimount pericardial bioprosthesis for aortic calcified stenosis: 18-year experience with 1133 patients. | |
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MedLine Citation:
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PMID: 17152784 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND AIM OF THE STUDY: Aortic stenosis (AS) is the most important cause of aortic valve disease, its prevalence increasing with patient age. The present study formed part of a long-term evaluation on use of the Perimount pericardial valve for aortic calcified stenosis. METHODS: A total of 1133 consecutive patients who underwent aortic valve replacement (AVR) with a Perimount pericardial bioprosthesis for degenerative AS between July 1984 and December 2003 at the authors' institution, was followed up in 2004. Among the patients (716 males, 417 females; mean age 72.6 years), 997 were in sinus rhythm, and the mean NYHA functional class was 2.3. Preoperative echocardiography indicated a mean gradient of 56 mmHg, a peak gradient of 89 mmHg, and an effective orifice area of 0.6 cm2. Associated procedures were required in 336 patients. RESULTS: All patients but 18 (1.5%) were followed up for an average of 5.5 years postoperatively; thus, the total follow up was 6,180 patient-years. Operative mortality was 2.8% (n=32), and there were 330 late deaths. At 18 years the actuarial survival rate was 22 +/- 4%. Among the 725 patients followed, 80% were in sinus rhythm and 98% in NYHA classes I or II. Valve-related complications included 39 thromboembolic episodes, 24 endocarditis, 22 anticoagulant-related hemorrhage, 28 reoperations, and 19 structural valve failures. A total of 54 patients died from valve-related causes (13 embolic events, two endocarditis, two hemorrhage, one structural failure, 36 unknown causes), and 57 died from cardiac failure. Neither thrombosis nor hemolysis was observed. At 18 years, freedom from embolism was 92 +/- 2%, from endocarditis 93 +/- 4%, from hemorrhage 95 +/- 2%, from reoperation 62 +/- 11%, from valve failure 68 +/- 12%, and from all complications 47 +/- 8%. Among patients aged >60 years, the 18-year actuarial freedom from reoperation was 76 +/- 14%, and from valve failure 85 +/- 8%. CONCLUSION: With a low rate of valve-related events at 18 years, and an especially low rate of structural failure, the Perimount pericardial prosthesis is a reliable choice for patients with aortic calcified stenosis. |
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Authors:
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Michel R Aupart; Alain Mirza; Yvon A Meurisse; Agnes L Sirinelli; Paul H Neville; Michel A Marchand |
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Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: The Journal of heart valve disease Volume: 15 ISSN: 0966-8519 ISO Abbreviation: J. Heart Valve Dis. Publication Date: 2006 Nov |
Date Detail:
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Created Date: 2006-12-08 Completed Date: 2007-01-30 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9312096 Medline TA: J Heart Valve Dis Country: England |
Other Details:
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Languages: eng Pagination: 768-75; discussion 775-6 Citation Subset: IM |
Affiliation:
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Unit of Cardiac Surgery, A. Trousseau Hospital and F. Rabelais University, Tours, France. aupart@med.univ-tours.fr |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Aortic Valve / surgery* Aortic Valve Stenosis / mortality*, surgery* Bioprosthesis / statistics & numerical data* Calcinosis / mortality*, surgery* Equipment Failure Analysis Female France / epidemiology Heart Valve Prosthesis / statistics & numerical data* Humans Longitudinal Studies Male Middle Aged Prosthesis Design Risk Assessment / methods Risk Factors Survival Analysis Survival Rate Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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