Age and valve size effect on the long-term durability of the Carpentier-Edwards aortic pericardial bioprosthesis
Age and valve size effect on the long-term durability of the Carpentier-Edwards aortic pericardial bioprosthesis
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DOI：
10.1016/s0003-4975(01)02992-7
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发表时间：
2001-09-01
影响因子：
4.6
通讯作者：
Okies, JE
中科院分区：
文献类型：
--
作者：
Banbury, MK;Cosgrove, DM;Okies, JE
背景人工心脏瓣膜的耐久性随着时间和年龄的增长而降低。然而，主动脉Carpentier-Edwards支架牛心包假体的耐久性的时间尺度和决定因素是不完全的特征。1981年9月至1984年1月，267例患者在四个中心接受了心包主动脉瓣假体植入术。植入时的平均年龄为65 ± 12岁（范围21 - 86岁）。平均随访12 +/- 4.5年。主要终点是结构性瓣膜功能障碍（SVD）的取出，在死亡作为竞争风险的背景下进行多变量分析。5年、10年和15年时，免于因SVD取出的比率分别为99%、94%和77%。瓣膜SVD风险随时间和植入时年龄的增加呈指数增加（p = 0.0001）;未可靠证明瓣膜尺寸过小的风险增加（p = 0.1）。考虑到死亡的竞争风险，65岁或以上的患者在15年内因SVD取出的可能性小于10%。该带支架心包主动脉生物瓣膜的耐久性极佳，证明其可用于65岁或以上患者。(C)2001年由胸外科医师协会出版。
Background. Bioprosthesis durability decreases with time and younger age. However, the time-scale and determinants of durability of the aortic Carpentier-Edwards stented bovine pericardial prosthesis are incompletely characterized.Methods. Between September 1981 and January 1984, 267 patients underwent implantation of the pericardial aortic prosthesis at four centers. Mean age at implant was 65 +/- 12 years (range 21 to 86 years). Follow-up averaged 12 +/- 4.5 years. The primary end point was explant for structural valve dysfunction (SVD), which was analyzed multivariably in the context of death as a competing risk.Results. Freedom from explant due to SVD was 99%, 94%, and 77% at 5, 10, and 15 years. Risk of SVD increased exponentially with time and younger age (p = 0.0001) at implantation; an increased risk of small valve size was not reliably demonstrated (p = 0.1). Considering the competing risk of death, patients aged 65 years or older had a less than 10% chance of explant for SVD by 15 years.Conclusions. Durability of this stented pericardial aortic bioprosthesis is excellent and justifies its use in patients aged 65 or older. (C) 2001 by The Society of Thoracic Surgeons.