Intermediate clinical results after aortic valve replacement with the carpentier-edwards pericardial bioprosthesis

From January 1986 through December 1993, 482 patients underwent aortic valve replacement with the CarpentierEdwards pericardial bioprosthesis at our institution. Patients ranged in age from 26 to 87 years (mean, 72.5 ± 7.1 years), and 59.8% of them were men. Pure or predominant aortic stenosis was the indication for operation in 80.1% of the patients. Most (75.4%) of the patients were in New York Heart Association functional class III or IV preoperatively because of dyspnea. Isolated aortic valve replacement was performed in 265 patients (55.0%). The most frequent concomitant procedure was aortocoronary bypass grafting (38.4%). All patients were followed up for as many as 7 years postoperatively (average, 1.7 ± 1.7 years). Twenty-six patients (5.4%) died within 30 days postoperatively; 53 patients died during the remainder of the follow-up period. The actuarial survival rate was 74.0% ± 3.6% at 5 years and 59.7% ± 7.5% at 7 years postoperatively. There were 12 valve-related deaths, and these were due to endocarditis (n = 3), thromboembolism (n = 5), anticoagulant-related hemorrhage (n = 2), reoperation necessitated by structural deterioration (n = 1), and sudden death (n = 1). After 7 years, the freedom from thromboembolic events was 86.6% ± 3.8%, the freedom from anticoagulant-related hemorrhage was 98.0% .9% and the freedom from reoperation was 90.9% .3%. There was only one structural failure, and this occurred at 6 years postoperatively.