[Carpentier's supra-annular bioprosthesis in aortic position: a mid-term evaluation]

Abstract

The aim of this study was to assess the medium and long-term results of the Carpentier-Edwards supra-annular (CESA 2650) bioprosthesis. From the end of 1984 to January 1993, 160 patients aged 71.6 +/- 8.6 years underwent aortic valve replacement alone or associated with coronary revascularisation. The postoperative mortality was 11 patients (6.8%): follow-up included 749 patient-years with an average period of 60 +/- 29 months, which was complete in 96% of operated patients. The late mortality was 30 patients (4% patients/year): the actuarial 5 year and 10 year survival was 78.6% and 59.1% respectively (hospital mortality included). The linear complications rates were: major thromboembolism: 1.3% patients/year; structural deterioration: 1.5% patients/year; reoperation: 0.75% patients/year; total morbid/fatal complications: 5% patients/year. Despite the limited follow-up, the authors' analysis confirmed the low rate of structural deterioration requiring reoperation, especially in patients over 70 years of age in whom there were no cases of reoperation at 9 years. They conclude that the medium-term results of the CESA 2650 bioprosthesis are comparable to those of first generation porcine bioprostheses: the absence of reoperation related to valve complications in the over 70s during the study period suggests that this is the replacement of choice in this category of patients.