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Ann Thorac Surg 1988;46:155-162
© 1988 The Society of Thoracic Surgeons
From Vancouver General Hospital and St. Paul's Hospital, The University of British Columbia, Vancouver, BC, Canada
* Address reprint request to Dr. Jamieson, Division of Cardiovascular and Thoracic Surgery, Department of Surgery, The University of British Columbia, 910 W 10th Ave, Vancouver, BC, Canada V5Z 4E3.
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%. The aortic valve prosthesis performed superiorly in the younger and older age groups while in the intermediate group there was no difference in the performance of aortic and mitral valve prostheses.
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W.R. E. Jamieson, A. I. Munro, L. H. Burr, E. Germann, R. T. Miyagishima, and H. Ling Influence of Coronary Artery Bypass and Age on Clinical Performance After Aortic and Mitral Valve Replacement With Biological and Mechanical Prostheses Circulation, November 1, 1995; 92(9): 101 - 106. [Abstract] [Full Text]
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W. R. Eric Jamieson, A. I. Munro, R. T. Miyagishima, P. Allen, L. H. Burr, and G. F. O. Tyers Carpentier-edwards standard porcine bioprosthesis: Clinical performance to seventeen years Ann. Thorac. Surg., October 1, 1995; 60(4): 999 - 1007. [Abstract] [PDF]
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D. M. Cosgrove, B. W. Lytle, P. C. Taylor, M. T. Camacho, R. W. Stewart, P. M. McCarthy, D. P. Miller, M. R. Piedmonte, and F. D. Loop The Carpentier-Edwards pericardial aortic valve: Ten-year results J. Thorac. Cardiovasc. Surg., September 1, 1995; 110(3): 651 - 662. [Abstract] [Full Text]
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T. J. Edwards, S. A. Livesey, I. A. Simpson, J. L. Monro, and J. Keith Ross Biological valves beyond fifteen years: The wessex experience Ann. Thorac. Surg., August 1, 1995; 60(suppl_2): S211 - S215. [Abstract] [PDF]
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K. L. Yun, D. Craig Miller, K. A. Moore, R. Scott Mitchell, P. E. Oyer, E. B. Stinson, R. C. Robbins, B. A. Reitz, and N. E. Shumway Durability of the hancock MO bioprosthesis compared with standard aortic valve bioprostheses Ann. Thorac. Surg., August 1, 1995; 60(suppl_2): S221 - S228. [Abstract] [PDF]
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W. R. Eric Jamieson, L. H. Burr, G. Frank, O. Tyers, R. T. Miyagishima, M. T. Janusz, H. Ling, G. J. Fradet, J. MacNab, F. Chan, et al. Carpentier-Edwards supraannular porcine bioprosthesis: Clinical performance to twelve years Ann. Thorac. Surg., August 1, 1995; 60(suppl_2): S235 - S240. [Abstract] [PDF]
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J. M. Bernal, J. M. Rabasa, R. Lopez, J. Francisco Nistal, R. Muniz, and J. M. Revuelta Durability of the Carpentier-Edwards porcine bioprosthesis: Role of age and valve position Ann. Thorac. Surg., August 1, 1995; 60(suppl_2): S248 - S252. [Abstract] [PDF]
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L. H. Burr, W. R. Eric Jamieson, A. Ian Munro, R. T. Miyagishima, and E. Germann Porcine bioprostheses in the elderly: Clinical performance by age groups and valve positions Ann. Thorac. Surg., August 1, 1995; 60(suppl_2): S264 - S269. [Abstract] [PDF]
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D. F. Pupello, L. N. Bessone, S. P. Hiro, E. Lopez-Cuenca, M. S. Glatterer Jr, W. W. Angell, J. C. Brock, M. J. Alkire, E. G. Izzo, G. Sanabria, et al. Bioprosthetic valve longevity in the elderly: An 18-year longitudinal study Ann. Thorac. Surg., August 1, 1995; 60(suppl_2): S270 - S275. [Abstract] [PDF]
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W. W. Angell, D. F. Pupello, L. N. Bessone, S. P. Hiro, E. Lopez-Cuenca, M. S. Glatterer Jr, and G. Ebra Influence of coronary artery disease on structural deterioration of porcine bioprostheses Ann. Thorac. Surg., August 1, 1995; 60(suppl_2): S276 - S281. [Abstract] [PDF]
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W. R. Eric Jamieson, D. Craig Miller, C. W. Akins, A. Ian Munro, D. D. Glower, K. A. Moore, and C. Henderson Pregnancy and bioprostheses: Influence on structural valve deterioration Ann. Thorac. Surg., August 1, 1995; 60(suppl_2): S282 - S287. [Abstract] [PDF]
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K. Wong, S. Shad, P. D. Waterworth, A. Khaghani, J. R. Pepper, and M. H. Yacoub Early experience with the toronto stentless porcine valve Ann. Thorac. Surg., August 1, 1995; 60(suppl_2): S402 - S405. [Abstract] [PDF]
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K. Holper, M. Wottke, T. Lewe, L. Baumer, H. Meisner, S.-U. Paek, and F. Sebening Bioprosthetic and mechanical valves in the elderly: Benefits and risks Ann. Thorac. Surg., August 1, 1995; 60(suppl_2): S443 - S446. [Abstract] [PDF]
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P. S. U. Myken, K. Caidahl, P. Larsson, S. Larsson, I. Wallentin, and H. E. Berggren Mechanical versus biological valve prosthesis: A ten-year comparison regarding function and quality of life Ann. Thorac. Surg., August 1, 1995; 60(suppl_2): S447 - S452. [Abstract] [PDF]
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G. J. Fradet, W. R. Eric Jamieson, J. G. Abel, S. V. Lichtenstein, R. T. Miyagishima, H. Ling, G. Frank, and O. Tyers Clinical performance of biological and mechanical prostheses Ann. Thorac. Surg., August 1, 1995; 60(suppl_2): S453 - S458. [Abstract] [PDF]
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U. Bortolotti, A. Milano, L. Testolin, V. Tursi, A. Mazzucco, and V. Gallucci Influence of type of prosthesis on late results after combined mitral-aortic valve replacement Ann. Thorac. Surg., July 1, 1991; 52(1): 84 - 91. [Abstract] [PDF]
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E. L. Jones, W. S. Weintraub, J. M. Craver, R. A. Guyton, C. L. Cohen, V. E. Corrigan, and C. R. Hatcher Jr Ten-year experience with the porcine bioprosthetic valve: Interrelationship of valve survival and patient survival in 1,050 valve replacements Ann. Thorac. Surg., March 1, 1990; 49(3): 370 - 384. [Abstract] [PDF]
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A. Starr and G. L. Grunkemeier The Expected Lifetime of Porcine Valves Ann. Thorac. Surg., September 1, 1989; 48(3): 317 - 318. [PDF]
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L. C. Pelletier, M. Carrier, Y. Leclerc, G. Lepage, P. deGuise, and I. Dyrda Porcine versus pericardial bioprostheses: A comparison of late results in 1,593 patients Ann. Thorac. Surg., March 1, 1989; 47(3): 352 - 361. [Abstract] [PDF]
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