Hemodynamic stability during 17 years of the Carpentier-Edwards aortic pericardial bioprosthesis. 2002

Michael K Banbury, and Delos M Cosgrove, and James D Thomas, and Eugene H Blackstone, and Jeevanantham Rajeswaran, and J Edward Okies, and Robert M Frater
Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, Ohio 44195, USA. banburm@ccf.org

BACKGROUND Long-term stability of the hemodynamic performance of commercially available Carpentier-Edwards stented bovine pericardial aortic bioprostheses (Perimount RSR) is unknown. To anticipate the fate of this bioprosthesis, we examined its hemodynamic performance up to 17 years using echocardiographic studies in a Premarket Approval cohort. METHODS Of 267 patients at four institutions in the Premarket Approval cohort, 85 had a total of 168 echocardiographic studies during a 17-year period of yearly follow-up examinations. These were reviewed and quantified in a core echocardiographic facility. Longitudinal data analysis was used to account for repeated, censored data. RESULTS Mean transvalvular gradient was inversely related to prosthesis size (p = 0.01), and possibly (p = 0.06) increased somewhat during the first 10 years of follow-up, then stabilized. Effective orifice area was larger in larger valve sizes (p = 0.01), declined somewhat during the first 10 years, and then began to increase again. Ejection fraction declined minimally (p = 0.2). In contrast to the rather stable hemodynamics, aortic regurgitation steadily increased from none to 1 to 2+ (p = 0.005), but rarely (< 10% at 17 years) progressed to 3+ or 4+. CONCLUSIONS The Carpentier-Edwards aortic pericardial bioprosthesis can be anticipated to have an acceptable long-term transvalvular gradient and effective orifice size that will change trivially up to 17 years after implantation. Mild aortic regurgitation will develop progressively. This anticipated hemodynamic resilience supports continued clinical use of the Perimount Carpentier-Edwards bovine pericardial stented bioprosthesis.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D004452 Echocardiography Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic. Echocardiography, Contrast,Echocardiography, Cross-Sectional,Echocardiography, M-Mode,Echocardiography, Transthoracic,Echocardiography, Two-Dimensional,Transthoracic Echocardiography,2-D Echocardiography,2D Echocardiography,Contrast Echocardiography,Cross-Sectional Echocardiography,Echocardiography, 2-D,Echocardiography, 2D,M-Mode Echocardiography,Two-Dimensional Echocardiography,2 D Echocardiography,Cross Sectional Echocardiography,Echocardiography, 2 D,Echocardiography, Cross Sectional,Echocardiography, M Mode,Echocardiography, Two Dimensional,M Mode Echocardiography,Two Dimensional Echocardiography
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006350 Heart Valve Prosthesis A device that substitutes for a heart valve. It may be composed of biological material (BIOPROSTHESIS) and/or synthetic material. Prosthesis, Heart Valve,Cardiac Valve Prosthesis,Cardiac Valve Prostheses,Heart Valve Prostheses,Prostheses, Cardiac Valve,Prostheses, Heart Valve,Prosthesis, Cardiac Valve,Valve Prostheses, Cardiac,Valve Prostheses, Heart,Valve Prosthesis, Cardiac,Valve Prosthesis, Heart
D006439 Hemodynamics The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM. Hemodynamic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

Related Publications

Michael K Banbury, and Delos M Cosgrove, and James D Thomas, and Eugene H Blackstone, and Jeevanantham Rajeswaran, and J Edward Okies, and Robert M Frater
February 2001, The Annals of thoracic surgery,
Michael K Banbury, and Delos M Cosgrove, and James D Thomas, and Eugene H Blackstone, and Jeevanantham Rajeswaran, and J Edward Okies, and Robert M Frater
March 1986, Archives des maladies du coeur et des vaisseaux,
Michael K Banbury, and Delos M Cosgrove, and James D Thomas, and Eugene H Blackstone, and Jeevanantham Rajeswaran, and J Edward Okies, and Robert M Frater
September 1988, Journal of cardiac surgery,
Michael K Banbury, and Delos M Cosgrove, and James D Thomas, and Eugene H Blackstone, and Jeevanantham Rajeswaran, and J Edward Okies, and Robert M Frater
January 1978, Catheterization and cardiovascular diagnosis,
Michael K Banbury, and Delos M Cosgrove, and James D Thomas, and Eugene H Blackstone, and Jeevanantham Rajeswaran, and J Edward Okies, and Robert M Frater
August 1979, The American journal of cardiology,
Michael K Banbury, and Delos M Cosgrove, and James D Thomas, and Eugene H Blackstone, and Jeevanantham Rajeswaran, and J Edward Okies, and Robert M Frater
July 2002, The Journal of thoracic and cardiovascular surgery,
Michael K Banbury, and Delos M Cosgrove, and James D Thomas, and Eugene H Blackstone, and Jeevanantham Rajeswaran, and J Edward Okies, and Robert M Frater
May 2006, The Journal of heart valve disease,
Michael K Banbury, and Delos M Cosgrove, and James D Thomas, and Eugene H Blackstone, and Jeevanantham Rajeswaran, and J Edward Okies, and Robert M Frater
April 2004, The Annals of thoracic surgery,
Michael K Banbury, and Delos M Cosgrove, and James D Thomas, and Eugene H Blackstone, and Jeevanantham Rajeswaran, and J Edward Okies, and Robert M Frater
August 1995, [Zasshi] [Journal]. Nihon Kyobu Geka Gakkai,
Michael K Banbury, and Delos M Cosgrove, and James D Thomas, and Eugene H Blackstone, and Jeevanantham Rajeswaran, and J Edward Okies, and Robert M Frater
December 1998, The Annals of thoracic surgery,
Copied contents to your clipboard!