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Ann Thorac Surg 1982;34:625-633
© 1982 The Society of Thoracic Surgeons

Articles

Experience with the Carpentier-Edwards Porcine Valve Prosthesis in 700 Patients

Michael T. Janusz, M.D., F.R.C.S.(C), W.R. Eric Jamieson, M.D., F.R.C.S.(C)*, Peter Allen, M.D., F.R.C.S.(C), A. Ian Munro, M.D., F.R.C.S.(C), Robert T. Miyagishima, M.D., F.R.C.S.(C), Hernando Tutassura, M.D., F.R.C.S.(C), Lawrence H. Burr, M.D., F.R.C.S.(C), Alfred N. Gerein, M.D., F.R.C.S.(C), G. Frank O. Tyers, M.D., F.R.C.S.(C)

From the Division of Cardiovascular and Thoracic Surgery, Department of Surgery, University of British Columbia, Vancouver General Hospital and St. Paul's Hospital, Vancouver, BC, Canada

Accepted for publication March 18, 1982.

* Address reprint requests to Dr. W. R. E. Jamieson, Division of Cardiovascular and Thoracic Surgery, Department of Surgery, U.B.C., Willow Cardiothoracic Unit, Vancouver General Hospital, Vancouver, BC, Canada V5Z 1M9

The Carpentier-Edwards porcine valve prosthesis has afforded our patients a satisfactory quality of life and a low incidence of valve-related complications at follow-up periods of up to five years. From December, 1975 to March, 1980, 768 prostheses were implanted in 700 patients (aortic valve replacement [AVR], 334; mitral valve replacement [MVR], 292; tricuspid valve replacement [TVR], 6; and multiple valve replacement, 68). One hundred and thirty-seven patients (19.6%) had had previous cardiac operations. Concomitant aortocoronary bypass was performed in 127 patients (18.1%). There were 52 hospital deaths, for a mortality of 7.4% (AVR, 4.8%; MVR, 9.2%; multiple valve replacement, 11.8%). Total follow-up was 1,047 patient-years (range, 6 to 60 months, mean, 19.4 months). There were 33 late deaths (AVR, 1.7% per patient-year; MVR, 4.0% per patient-year; multiple valve replacement, 8.1% per patient-year). Eight percent of AVR patients and 47% of MVR and multiple valve replacement patients were taking anticoagulants. The valve-related complications (expressed as events per 100 patient-years) were as follows: (1) thromboembolism (AVR, 0.94; MVR, 1.42; multiple valve replacement, 4.62); (2) infective endocarditis (AVR, 0.94; MVR, 0.24; multiple valve replacement, 2.31); (3) periprosthetic leak (AVR, 0.94; MVR, 0.71; multiple valve replacement, 3.46); and (4) valve dysfunction (MVR, 0.24). The only case of valve dysfunction was a calcified mitral prosthesis in a 13-year-old girl. Actuarial survival, including operative deaths, was as follows: AVR, 90.5% at 36 months; MVR, 84% at 36 months; and multiple valve replacement, 74% at 24 months. Of surviving patients, 93.6% were in New York Heart Association Class I or II at follow-up evaluation.




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