Bioprosthetic mitral valve replacement in patients aged 65 years or younger: long-term outcomes with the Carpentier–Edwards PERIMOUNT pericardial valve†
| Autor: | Emmanuelle Vermes, Claudia Loardi, Michel Aupart, Elias Karam, Clemence Pantaleon, Fabrice Ivanes, Jean Marc El-Arid, Pascal Candolfi, Thierry Bourguignon, Fabien Espitalier |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Reoperation Pulmonary and Respiratory Medicine medicine.medical_specialty medicine.medical_treatment Kaplan-Meier Estimate 030204 cardiovascular system & hematology Young Adult 03 medical and health sciences Postoperative Complications 0302 clinical medicine Risk of mortality Long term outcomes Humans Medicine In patient Young adult Bioprosthetic mitral valve replacement Aged Bioprosthesis Heart Valve Prosthesis Implantation business.industry Operative mortality Mitral valve replacement General Medicine Perioperative Middle Aged Surgery Treatment Outcome 030228 respiratory system Heart Valve Prosthesis Mitral Valve Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Journal of Cardio-Thoracic Surgery. 54:302-309 |
| ISSN: | 1873-734X 1010-7940 |
| DOI: | 10.1093/ejcts/ezy029 |
| Popis: | Objectives Mitral valve replacement using a bioprosthesis remains controversial in young patients because data on long-term outcomes are missing. This study evaluated the long-term results of the PERIMOUNT pericardial mitral bioprosthesis in patients aged 65 years or younger. Methods From 1984 to 2010, 148 Carpentier-Edwards PERIMOUNT mitral bioprostheses were implanted in 148 patients aged 65 years or younger. Baseline clinical, perioperative and follow-up data were recorded prospectively. Structural valve deterioration (SVD) was defined by strict echocardiographic assessment. Results The mean follow-up period was 8.6 ± 5.5 years, for a total of 1269 valve-years. Operative mortality rate was 2.0%. Fifty-one late deaths occurred (linearized rate 4.0% per valve-year). Actuarial survival rates averaged 70 ± 4%, 53 ± 6% and 31 ± 7% after 10, 15 and 20 years of follow-up, respectively. Actuarial freedom from SVD at 10, 15 and 20 years was 78 ± 5%, 47 ± 7% and 19 ± 7%, respectively. Reoperation was associated with no operative mortality. Actuarial freedom from reoperation due to SVD at 10, 15 and 20 years was 82 ± 4%, 50 ± 6% and 25 ± 8%, respectively. Competing risk analysis demonstrated an actual risk of explantation secondary to SVD at 20 years of 44 ± 5%. Expected valve durability was 14.2 years for this age group. Conclusions In the selected patients aged 65 years or younger undergoing mitral valve replacement with a pericardial bioprosthesis, the expected valve durability was 14.2 years. Reoperation for SVD was associated with a low risk of mortality. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|