Structural deterioration in Carpentier-Edwards standard and supraannular porcine bioprostheses

The Carpentier-Edwards standard (CE-S) porcine bioprosthesis was implanted in 1214 operations (1975 to 1985) and the Carpentier-Edwards supraannular (CESAV) bioprosthesis was implanted in 2,489 operations (1982 to 1992 inclusive). The early mortality was 7.6% and 7.4% for the CE-S and CE-SAV groups, respectively; the late mortality was 5.3% per patient-year and 4.9% per patient-year, respectively. The cumulative follow-up was 9,968 patient-years for the CE-S group and 12,784 patientyears for the CE-SAV group. Concomitant procedures were performed in 26.8% of the patients who received a CE-S and in 40.9% of those who received a CE-SAV ( p p p = not significant). The freedom from SVD at 10 years did not differ between the CE-SAV and CE-S groups (including and excluding stent dehiscence for CE-SAV MVRs) ( p = not significant), but trends were revealed at 10 years (CE-S, CE-SAV, and CE-SAV without SVD, respectively): for patients aged 36 to 50 years it was 64.1% ± 5.5%, 67.8% ± 7.1%, and 70.8% ± 6.8%; for those aged 51 to 64 years it was 73.0% ± 3.9%, 72.1% ± 4.4%, and 76.9% ± 4.2%; and for those aged 65 to 69 years it was 66.6% ± 7.5%, 74.0% ± 6.3%, and 79.3% ± 5.9%. The CE-SAV porcine bioprosthesis appears to have a greater freedom from structural valve deterioration than the CE-S when stent dehiscence cases are not considered in the comparison. We consider the cause of stent dehiscence identified and corrected.