15-Year Comparison of Supra-Annular Porcine and PERIMOUNT Aortic Bioprostheses

Abstract

The second-generation Carpentier-Edwards bioprostheses, the supra-annular porcine valve and the PERIMOUNT pericardial valve, have been evaluated longitudinally for several years. This study compared clinical performance over 15 years. Aortic valve replacement was performed with a supra-annular porcine valve in 1,823 patients (group 1) aged 19-89 years (mean, 68.9 +/- 10.9 years) and with a PERIMOUNT pericardial bioprosthesis in 1,430 patients (group 2) aged 16-90 years (mean, 69.5 +/- 10.4 years). The groups were similar except for concomitant coronary artery bypass in 43% of group 1 and 18% of group 2 ( p < 0.001). Overall survival at 15 years was 29.3% +/- 1.5% for group 1 and 35.2% +/- 3.1% for group 2 ( p = 0.0009). The actual freedom from valve-related mortality was 88.5% +/- 0.9% for group 1 and 84.9% +/- 1.7% for group 2. The actual freedom from structural valve deterioration at 15 years was similar overall, and for patients aged > 60 years, between the groups, but was dissimilar (group 2 > group 1) for age </= 60 years. The predictors of structural valve deterioration were valve type (group 1 > group 2), sex (male > female), age, and concomitant coronary artery bypass. Both bioprostheses provided satisfactory clinical performance at 15 years after aortic valve replacement.

Long-Term Clinical and Hemodynamic Performance of the Hancock II Versus the Perimount Aortic Bioprostheses

“…[1][2][3][4][5][6][7] In the present study, patients receiving the Perimount were more likely to be in atrial fibrillation preoperatively and to be female compared to patients receiving the Hancock II. However, mean preoperative aortic root diameter was similar between the Perimount and Hancock II groups.…”

“…Freedom from reoperation, structural valve deterioration, and prosthetic valve endocarditis were in accordance with previously published noncomparative data. [1][2][3][4][5][6][7] One of the findings of this study was that transprosthesis gradients were persistently higher with the Hancock II relative to the Perimount. However, these higher gradients were not associated with any difference in LV mass regression.…”

“…Observational studies from North America and Europe have reported excellent clinical outcomes after aortic valve replacement (AVR) with either the Hancock II or the Perimount. [1][2][3][4][5][6][7] The Medtronic Hancock II offers 10-and 15-year survival ranging from 63% to 67% and 35% to 47%, respectively. [1][2][3][4] The Perimount performs similarly, with 10-and 15-year survival ranging from 53% to 69% and 35% to 68%, respectively.…”

“…[1][2][3][4] The Perimount performs similarly, with 10-and 15-year survival ranging from 53% to 69% and 35% to 68%, respectively. [5][6][7] Reported freedom from structural valve deterioration, reoperation, prosthetic valve endocarditis, and thromboembolism are favorable after AVR with either the Hancock II or the Perimount. [1][2][3][4][5][6][7] Of those studies that have included sizeable cohorts, most have involved multiple centers.…”

“…[5][6][7] Reported freedom from structural valve deterioration, reoperation, prosthetic valve endocarditis, and thromboembolism are favorable after AVR with either the Hancock II or the Perimount. [1][2][3][4][5][6][7] Of those studies that have included sizeable cohorts, most have involved multiple centers. Variability in perioperative and postoperative management therefore may have influenced long-term outcomes.…”