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Ann Thorac Surg 2001;71:S236-S239
© 2001 The Society of Thoracic Surgeons

Valvular bioprostheses over 15 years

Fifteen-year experience with the mitral Carpentier-Edwards PERIMOUNT pericardial bioprosthesis

Michel A. Marchand, MDa, Michel R. Aupart, MDa, Robert Norton, MDb, Ira R.A. Goldsmith, FRCSb, L. Conrad Pelletier, MDc, Michel Pellerin, MDc, Thomas Dubiel, MDd, Willem J. Daenen, MDe, Paul Herijgers, MDe, Filip P. Casselman, MDe, Michael P. Holden, FRCSf, Tirone E. David, MDg

a Department of Cardiothoracic Surgery and Cardiology, Hôpital Trousseau and Francois Rabelais University, Tours, France
b Department of Cardiothoracic Surgery and Cardiology, Walsgrave Hospital, Coventry, United Kingdom
c Department of Cardiothoracic Surgery and Cardiology, Institut de Cardiologie, Montreal, Quebec, Canada
d Department of Cardiothoracic Surgery and Cardiology, University Hospital, Uppsala, Sweden
e Department of Cardiothoracic Surgery and Cardiology, University Hospital, Gasthuisberg, Leuven, Belgium
f Department of Cardiothoracic Surgery and Cardiology, Freeman Hospital, Newcastle Upon Tyne, United Kingdom
g Department of Cardiothoracic Surgery and Cardiology, Toronto General Hospital, Toronto, Ontario, Canada

Address reprint requests to Dr Marchand, Department of Cardiac Surgery, C.H.U. Trousseau, 37044 Tours Cedex 1, France
e-mail: marchand{at}med.univ-tours.fr

Presented at the VIII International Symposium on Cardiac Bioprostheses, Cancun, Mexico, Nov 3–5, 2000.

Background. This multicenter study concerning the mitral PERIMOUNT valve previously reported clinical results at 12 years; this report updates the performance to 15 years postoperatively.

Methods. The 435 patients (mean age 60.7 ± 11.6 years; 41.1% male) underwent implantation with the PERIMOUNT valve between 1984 and 1989 at seven institutions. Follow-up was complete for 96.1% of the cohort. The mean follow-up was 8.1 ± 4.4 years (range 0 to 15.4 years) for a total of 3492 patient-years.

Results. There were 34 (7.8%) operative deaths, one (0.2%) valve related. The late mortality rate was 5.3%/patient-year (2.2%/patient-year valve related). At 14 years, the overall actuarial survival rate was 37.1% ± 3.3% (63.1% ± 4.4% valve related). Actuarial freedom from complications at 14 years was as follows: thromboembolism, 83.8% ± 3.2% (1.1%/patient-year); hemorrhage, 86.6% ± 3.2% (1.1%/patient-year); and explant due to structural valve deterioration (SVD), 68.8% ± 4.7%. Actual freedom from explant due to SVD was 83.4% ± 2.3%. Rates of structural failure decreased with increasing age at implant.

Conclusions. The Carpentier-Edwards PERIMOUNT Pericardial Bioprosthesis is a reliable choice for a tissue valve in the mitral position, especially in patients more than 60 years of age.




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