THE CARPENTIER-EDWARDS SUPRAANNULAR PORCINE BIOPROSTHESIS - CLINICAL-PERFORMANCE TO 8 YEARS OF A NEW GENERATION PORCINE BIOPROSTHESIS

The Carpentier-Edwards supra-annular porcine bioprosthesis has been utilized at the University of British Columbia since its introduction in 1982. The prosthesis was designed to improve hemodynamics with the supra-annular configuration and to reduce tissue failure with low-pressure glutaraldehyde preservation of the porcine aortic tissue. The prosthesis was inserted in 1,956 patients with 2,129 prostheses between 1982 and 1989. The mean age of the patient population was 62.7 years (range 13 to 87 years). The mean follow-up was 3.7 years per patient. The freedom from thromboembolism and antithromboembolic therapy-related hemorrhage at 8 years was 92% for aortic valve replacement (AVR), 83% for mitral valve replacement (MVR), and 92% for multiple valve replacement (MR) (p < 0.05, AVR > MR > MVR). The freedom from structural valve deterioration was 86% for AVR, 73% for MVR, and 96% for MR at 8 years (p < 0.05, AVR > MR > MVR). The freedom from nonstructural valve dysfunction and prosthetic valve endocarditis was not different between positions (p = NS). The freedom from valve-related mortality at 8 years was 98% for AVR, 94% for MVR, and 98% for MR (p < 0.05, AVR > MR > MVR). The freedom from residual morbidity was not different at 8 years (p = NS). The freedom from treatment failure (valve-related mortality and residual morbidity) was 96% for AVR, 89% for MVR, and 94% for MR (p < 0.05, AVR > MVR > MR). The freedom from all valve-related complications at 8 years was 74% for AVR, 54% for MVR, and 78% for MR (p < 0.05, AVR > MVR > MR). The Carpentier-Edwards supra-annular porcine bioprosthesis provides clinical performance characteristics similar to first generation porcine bioprostheses.