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Performance of the Carpentier-Edwards SAV and Hancock-II Porcine Bioprostheses
in Aortic Valve Replacement Experiences with the Carpentier-Edwards Supra-Annular Valve (CE-SAV) and Hancock II (H II) porcine bioprostheses were evaluated to determine freedom from structural valve deterioration (SVD) by reoperation in the aortic position. Between 1981 and 1994, 1,524 procedures with the CE-SAV, and 670 with the H II were conducted at two centers. Patient populations were differentiated by mean age, gender and valve size. Analyses included actuarial and actual freedom from SVD and evaluation of predictors of SVD. Actuarial freedom from SVD at 15 years for patients aged ≥65 years was 91.5 ± 2.9% for CE-SAV, and 100% for H II (p = NS); actual freedom was 96.4 ± 1.0% and 100%, respectively. For patients aged 66-70 years, actuarial freedom from SVD was 87.0 ± 6.0% for CE-SAV and 100% for H II (p = NS); actual rates were 93.6 ± 2.3% and 100%, respectively. For patients aged >70 years, actuarial freedom from SVD was 96.9 ± 1.5% for CE-SAV, and 100% for H II (p = NS); actual freedom was 98.8 ± 0.5% and 100%, respectively. In patients aged <65 years, actuarial freedom from SVD at 15 years favored the H II (p = 0.412); actual freedom provided the same outcome. Valve type was not predictive of SVD for age groups ≤60 years, >60 years, 61-70 years and >70 years, but was predictive for the overall population (p = 0.0363), as was age and previous valve replacement. In conclusion, the CE-SAV and H II both provide satisfactory clinical performances, with a low incidence of SVD, and no significant difference in SVD was shown in patients aged ≥65, 66-70, or >70 years. There was a trend to less SVD by actual analysis for the H II in patients aged <65 years. This evaluation must be considered as work-in-progress because of the limited number of patients at risk at 15 years, especially with the H II prosthesis. |
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