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The Journal of Cardiovascular Surgery 2001 June;42(3):317-22

language: English

Aortic valve replacement with the composite LabcorTM porcine bioprosthesis in the elderly

Pavie A. J., Nzomvuama A. N., Bonnet N., Bors V. H., Gandjbakhch I.

From the Tho­racic and Car­di­o­vas­cular Sur­gery Depart­ment Hôpital ''La ­Pitié-­Salpétrière'', ­Paris, ­France


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Back­ground. ­This ­paper ­presents the anal­ysis of clin­ical ­results of the com­posite por­cine ­Labcor™ bio­pros­thesis in the replace­ment of ­aortic ­valves in the eld­erly.
­Methods. ­This ret­ro­spec­tive ­study was car­ried out in the Tho­racic and Car­di­o­vas­cular Sur­gical Depart­ment, La ­Pitié-­Salpétrière Hos­pital, ­Paris, for replace­ment of cal­ci­fied, ste­nosed ­aortic ­valves ­between 1988 and 1995. It ­involved a ­series of 100 ­patients ­aged 70 and ­over (mean: 80±5 ­years ­ranging ­from 70 to 90). ­There ­were 63 ­female and 37 ­male ­patients. Pre­op­er­a­tively, ­five ­patients ­were in ­NYHA ­Class I, 23 in ­Class II, 65 in ­Class III and 7 in ­Class IV.
­Results. Fif­teen ­patients ­died in the ­early post­op­er­a­tive ­stage and 13 ­during the ­follow-up ­period. ­There was no evi­dence of ­valve ­failure. The ­average ­follow-up was 32 ­months and the actu­arial sur­vival ­rate at 5 ­years was 74±5%. Com­pli­ca­tions due to ­bleeding ­occurred in 3 ­patients ­taking anti­co­ag­u­lant treat­ment. ­There ­were nei­ther val­vular throm­bosis nor embo­lism. Two ­patients pre­sented ­with pros­thetic endo­car­ditis. Two ­patients ­received a reop­er­a­tion ­because of ­leakage (1 ­septic). The ­five-­year ­follow-up ­showed ­that 96% of ­patients did not ­require fur­ther sur­gery. ­When ­this ­study was com­pleted, 83% of ­patients ­were in ­Class I or II ­versus 71% in ­Class III or IV ­prior to sur­gery.
Con­clu­sions. In the ­early/­middle ­follow-up ­term, the ­results ­obtained ­when ­replacing the ­aortic ­valve ­with the com­posite ­Labcor™ bio­pros­thesis in the eld­erly are sat­is­fying. Nev­er­the­less, fur­ther ­long-­term assess­ment is ­needed.

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