Mitral Valve Replacement Using Carpentier-Edwards Pericardial Bioprosthesis in Patients With Rheumatic Heart Disease Aged Below 40 Years: 17-Year Results

Heart Lung Circ. 2018 Jul;27(7):864-871. doi: 10.1016/j.hlc.2017.05.147. Epub 2017 Aug 1.

Abstract

Background: This study was designed to evaluate patients aged less than 40 years implanted with tissue heart valves with respect to survival, thromboembolism, structural degeneration and quality of life.

Methods: Between January, 2000 and December, 2016, 132 patients (51 males) with rheumatic heart disease underwent mitral valve replacement using Carpentier-Edwards, perimount, pericardial bioprostheses. The patients' ages ranged between 12 and 39 years (mean±SD 30.12±5.51 years).

Results: The hospital and late mortality were 1.5% and 1.5% respectively. The total cumulative follow-up period was 1330.98 patient-years with a mean of 124.78±50.3 months (range, 1-204 months). The actuarial survival and actuarial event-free survival at 204 months was 96.9% (±0.01%) and 93.4%(±0.03%) respectively. There was one episode of thromboembolism (0.32 events per 100 patient years). Six (4.7%) patients underwent redo mitral valve replacement for severe bioprosthetic degeneration with stiffening and calcification using a Medtronic mechanical prosthesis (Medtronic Open Pivot, MN, USA).

Conclusions: We conclude that Carpentier-Edwards perimount pericardial prosthesis provides satisfactory clinical performance in a young population with a low risk of degeneration and other valve-related events.

Keywords: Bioprosthetic degeneration; Carpentier-Edwards pericardial prosthesis; Mitral valve replacement.

MeSH terms

  • Adolescent
  • Adult
  • Bioprosthesis*
  • Child
  • Echocardiography, Doppler
  • Female
  • Follow-Up Studies
  • Heart Valve Diseases / diagnosis
  • Heart Valve Diseases / etiology
  • Heart Valve Diseases / surgery*
  • Humans
  • Male
  • Mitral Valve / surgery*
  • Pericardium / transplantation*
  • Prosthesis Design
  • Rheumatic Heart Disease / complications
  • Rheumatic Heart Disease / mortality
  • Rheumatic Heart Disease / surgery*
  • Survival Rate / trends
  • Time Factors
  • Young Adult