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The Annals of Thoracic Surgery, Vol 46, 155-162, Copyright © 1988 by The Society of Thoracic Surgeons
WR Jamieson, LJ Rosado, AI Munro, AN Gerein, LH Burr, RT Miyagishima, MT Janusz and GF Tyers
Primary tissue failure (structural valve deterioration) has been documented
as the most prominent complication of porcine bioprostheses. The influence
of age on primary tissue failure has received limited consideration. From
1975 to 1986, 1,301 Carpentier-Edwards standard porcine bioprostheses were
implanted in 1,183 patients in 1,201 operations. Of the total number of
prostheses, 97.7% were implanted prior to 1983. The mean follow-up was 5.6
years and was 97.5% complete. Primary tissue failure was identified in 96
patients (98 operations) at reoperation (95) or autopsy (3). One hundred
four (104) prostheses were involved. Thirty-one failed after aortic valve
replacement (AVR), 49 after mitral valve replacement (MVR), and 24 after
multiple-valve replacement (18 patients). There were 47 male and 49 female
patients. The mean age at implantation was 47 years (range, 8 to 72 years).
The mean implantation time was 74.0 months. The freedom from primary tissue
failure at 10 years is 77.0 +/- 2.9% overall; for AVR, 83.1 +/- 3.7%; for
MVR, 72.1 +/- 4.9%; and for multiple-valve replacement, 65.5 +/- 7.8%. The
freedom from deterioration for patients less than 20 years of age is
significantly less than that for other age groups. The freedom from
deterioration increased by decades; the greatest freedom was noted in
patients 70 to 80 years old and 80 years old or older. The freedom from
deterioration at 10 years for patients less than 30 years of age is 26.8
+/- 17.2%; 30 to 59 years, 77.4 +/- 3.0%; and 60 years and older, 83.1 +/-
4.2%.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Carpentier-Edwards standard porcine bioprosthesis: primary tissue failure (structural valve deterioration) by age groups
Vancouver General Hospital, University of British Columbia, Canada.
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