The last generation of pericardial valves in the aortic position: Ten-year follow-up in 589 patients

Aupart, Michel; Sirinelli, A; Diemont, F; Meurisse, Y; Dreyfus, X; Marchand, M

doi:10.1016/0003-4975(95)00953-1

Cited by 52 publications

(37 citation statements)

References 22 publications

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“…16 In other series with similar mean ages, the freedom from SVD at 10 years was 92% for the Hancock II porcine bioprosthesis and ranged from 87% to 100% for the CE-P bioprosthesis. [4][5][6][7][8][9][10][11][12] The series reported by Neville and colleagues 5 revealed a 94% freedom at 12 years with the aortic CE-P bioprosthesis, but the mean age was 68 years. Banbury and coauthors 9 reported a freedom from SVD of 82% at 12 years with the CE-P valve, also in the aortic position, in patients with a mean age of 64 years.…”

Section: Discussionmentioning

confidence: 98%

“…Numerous publications have documented the freedom from SVD for aortic valve replacements for both the CE-P and second-generation porcine bioprostheses, especially the Carpentier-Edwards SupraAnnular (SAV) and Hancock II porcine bioprostheses, but no formal comparison has been undertaken. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] The performance of the CE-P and the second-generation porcine bioprostheses with regard to SVD for mitral valve replacements (MVRs) has not been documented.…”

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confidence: 99%

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Structural valve deterioration in mitral replacement surgery: Comparison of carpentier-edwards supra-annular porcine and perimount pericardial bioprostheses

Jamieson¹,

Marchand²,

Pelletier³

et al. 1999

The Journal of Thoracic and Cardiovascular Surgery

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Background: Bioprostheses preserved with glutaraldehyde, both porcine and pericardial, have been available as second-generation prostheses for valve replacement surgery. The performance with regard to structural valve deterioration with the Carpentier-Edwards supra-annular (CE-SAV) porcine bioprosthesis and the Carpentier-Edwards Perimount (CE-P) pericardial bioprosthesis (Baxter Healthcare Corp, Edwards Division, Santa Ana, Calif) was evaluated to determine whether there was a difference in mitral valve replacement. Methods: The CE-SAV bioprosthesis was implanted in 1266 overall mitral valve replacements (isolated mitral, 1066; mitral in multiple, 200) and the CE-P bioprosthesis in 429 overall mitral valve replacements (isolated mitral, 328; mitral in multiple, 101). The mean age of the CE-SAV population was 64.2 ± 12.2 years and that of the CE-P population, 60.7 ± 11.7 years (P = .0001). For the study, structural valve deterioration was diagnosed at reoperation for explantation. Results: The freedom from structural valve deterioration was evaluated to 10 years, and the freedom rates reported are at 10 years. For the overall mitral valve replacement groups, the actuarial freedom from deterioration was significant (P = .0001): CE-P > CE-SAV for 40 years or younger, 80% versus 60%; 41 to 50 years, 91% versus 61%; 51 to 60 years, 84% versus 69%; 61 to 70 years, 95% versus 75%. The older than 70-year group was 100% versus 92% (no significant difference). The actual freedom from structural valve deterioration also demonstrated the same pattern at 10 years: 40 years or younger, CE-P 82% versus CE-SAV 68%; 41 to 50 years, 92% versus 70%; 51 to 60 years, 90% versus 80%; 61 to 70 years, 97% versus 88%; and older than 70 years, 100% versus 97%. The independent risk factors of structural valve deterioration for the overall mitral valve replacement group were age and age groups and prosthesis type (CE-SAV > CE-P). The prosthesis type either in isolated replacement or in multiple replacement was not predictive of structural valve deterioration. The pathology of structural valve deterioration was different: 70% of CE-P failures were due to calcification and 57% of CE-SAV failures were due to combined calcification and leaflet tear.

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Section: Discussionmentioning

confidence: 98%

mentioning

confidence: 99%

Structural valve deterioration in mitral replacement surgery: Comparison of carpentier-edwards supra-annular porcine and perimount pericardial bioprostheses

Jamieson¹,

Marchand²,

Pelletier³

et al. 1999

The Journal of Thoracic and Cardiovascular Surgery

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“…39 Even though the actual mechanism of calcification in BHV is still poorly understood, it has been reported that structural deterioration is frequently accompanied by excessive calcification of the leaflets leading to valve stenosis and cuspal tears. 1,40 The deposition of calcified substances on BHV is commonly located at the cuspal commissures and basal attachments. 22,25 It was also reported that calcification occurred predominantly in the area where large leaflet flexion occurred resulting in both tensile and compressive stresses.…”

Section: Introductionmentioning

confidence: 99%

An Experimentally Derived Stress Resultant Shell Model for Heart Valve Dynamic Simulations

et al. 2006

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In order to achieve a more realistic and accurate computational simulation of native and bioprosthetic heart valve dynamics, a finite shell element model was developed. Experimentally derived and uncoupled in-plane and bending behaviors were implemented into a fully nonlinear stress resultant shell element. Validation studies compared the planar biaxial extension and three-point bending simulations to the experimental data and demonstrated excellent fidelity. Dynamic simulations of a pericardial bioprosthetic heart valve with the developed shell element model showed significant differences in the deformation characteristics compared to the simulation with an assumed isotropic bending model. The new finite shell element model developed in the present study can also incorporate various types of constitutive models and is expected to help us to understand the complex dynamics of native and bioprosthetic heart valve function in physiological and pathological conditions.

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“…A incidência de falência valvar em 10 anos é ao redor de 10 a 20% em pacientes adultos e 40 a 50% em 4 anos em crianças (13) . O estresse mecânico e o depósito lipídico nas células dos folhetos aórticos porcinos decorrentes da fixação com GDA têm sido indicados como os principais fatores que influenciam a calcificação (14)(15)(16)(17) . A suposição de que a calcificação possa estar relacionada ao uso do glutaraldeído despertou interesse no estudo de modificações no processo, como a adição de substâncias inibidoras da mineralização ou mesmo sua substituição por outros agentes fixadores.…”

Section: Introductionunclassified

Estudo comparativo da eficácia do etanol e do ácido L-glutâmico na prevenção da calcificação das cúspides e parede aórtica porcina: estudo experimental em ratos

Rosa

Costa

Mesquita

et al. 2002

Rev Bras Cir Cardiovasc

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Estudo comparativo da eficácia do etanol e do ácido L-glutâmico na prevenção da calcificação das cúspides e parede aórtica porcina: estudo experimental em ratos Rev Bras Cir Cardiovasc 2002; 17(2): 40-51.RBCCV George Ronald SONCINI DA ROSA*, Francisco Diniz Affonso da COSTA* **, Lismari MESQUITA*, Iseu de Santo Elias Affonso da COSTA* RESUMO: Introdução: As cúspides porcinas tratadas com glutaraldeído (GDA) são um dos tecidos biológicos mais utilizados em biopróteses, porém a calcificação tardia pós-implante constitui a causa predominante de sua falência.Objetivo: Analisar comparativamente dois métodos de prevenção da calcificação (etanol 80% e ácido L-glutâmico 0,8%) em cúspide e parede aórtica porcina implantadas no subcutâneo em ratos, tendo como grupo controle as cúspides e os segmentos de parede aórtica fixadas em glutaraldeído (GDA), num período de 15, 30 e 60 dias após implante.Material e Métodos: Foram utilizados 45 ratos jovens, distribuídos em 3 grupos contendo 15 animais cada, que por sua vez foram subdivididos em 3 subgrupos de 5 animais, nos quais foram implantados, em 2 bolsas no subcutâneo, uma cúspide e um segmento de parede aórtica em cada. Em cada grupo assim nominados: GDA (grupo controle), E80% (grupo cujas estruturas foram pré-tratadas com etanol 80%) e o AG 0,8% (grupo cujas estruturas foram pré-tratadas com ácido L-glutâmico 0,8%) foram realizadas a mensuração do cálcio e análise microscópica quanto à presença de calcificação (localização e intensidade da mesma) e de Infiltrado inflamatório (localização e tipo), no período de 15, 30 e 60 dias após implante.Resultados: Na mensuração do cálcio na cúspide aórtica encontrou-se no grupo E80% 15 dias (1,30±0,21 mg cálcio/mg tecido), E80% 30 dias (1,05±0,22 mg cálcio/mg tecido) e E80% 60 dias (0,53±0,42 mg cálcio/mg tecido); no grupo AG 0,8% 15 dias (12,17±0,66 mg cálcio/mg tecido), AG 0,8% 30 dias (15,31±2,82 mg cálcio/mg tecido) e AG 0,8% 60 dias (34,24±16,28 mg cálcio/mg tecido) com o grupo controle GDA 15 dias (12,44±2,26 mg cálcio/mg tecido), GDA 30 dias (13,44±3,34 mg cálcio/mg tecido) e GDA 60 dias (50,85±8,71 mg cálcio/mg tecido). Em relação à mensuração do cálcio na parede aórtica, encontrou-se no grupo de E80% 15 dias (4,62±0,68 mg cálcio/ mg tecido), E80% 30 dias (9,47 ± 2,59mg cálcio/mg tecido) e E80% 60 dias (23,56±7,75 mg cálcio/mg tecido) no grupo de AG 0,8% 15 dias (4,31±0,85 mg cálcio/mg tecido), AG 0,8% 30 dias (7,69±1,48 mg cálcio/mg tecido) e AG 0,8% 60 dias (20,50± 1,22 mg cálcio/mg tecido) com o grupo controle GDA 15 dias (7,34±1,32 mg cálcio/mg tecido), GDA 30 dias (9,28±0,76 mg cálcio/mg tecido) e GDA 60 dias (27,60±1,08 mg cálcio/mg tecido). Na avaliação microscópica da cúspide aórtica houve uma progressiva calcificação naquelas subme-

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The last generation of pericardial valves in the aortic position: Ten-year follow-up in 589 patients

Cited by 52 publications

References 22 publications

Structural valve deterioration in mitral replacement surgery: Comparison of carpentier-edwards supra-annular porcine and perimount pericardial bioprostheses

Structural valve deterioration in mitral replacement surgery: Comparison of carpentier-edwards supra-annular porcine and perimount pericardial bioprostheses

An Experimentally Derived Stress Resultant Shell Model for Heart Valve Dynamic Simulations

Estudo comparativo da eficácia do etanol e do ácido L-glutâmico na prevenção da calcificação das cúspides e parede aórtica porcina: estudo experimental em ratos

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