In the decision concerning the choice of valvular prosthesis, certain prostheses are considered to be standards of reference: this is the case of the Carpentier-Edwards Supra Annular 2650 porcine bioprosthesis. This study reports the results in a series of patients followed up for 12 years. Between 1983 and 1995, 1108 patients were implanted with this prosthesis for isolated aortic valve replacement. The majority of patients was elderly (mean 78.3 +/- 8.3 years). The follow-up rate was 94%, representing a total of 3 925 patient-years (average 4 +/- 3 years). The survival at 5, 10 and 12 years, operative mortality included, was 70.7%, 46% and 28%. Thromboembolic events to dehiscence represented the commonest complication (0.7% per patient-year). Structural valve degeneration (21 cases) (0.5% per patient-year) was a low risk complication up to 10 years but increased suddenly at the 11th year: age and gender were risk factors for this complication. The actuarial complication-free rate was 94% at 10 years and 82% at 12 years. Other complications were much less common (infectious endocarditis, haemorrage). The Carpentier-Edwards Supra Annular porcine bioprosthesis is associated with a low risk of complications after 10 years' follow-up, especially of valve degeneration. It remains a competitive choice in the register of valve prostheses. As with the other bioprostheses, the main indications are observed in elderly patients.
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J Clin Med
January 2025
Division of Internal Medicine, IRCCS MultiMedica, 20123 Milan, Italy.
During the last few years, significant pathophysiological differences between heart failure (HF) patients with "normal" ejection fraction (EF) (50% to 64%) and those with supra-normal EF (≥65%) have been highlighted. However, these distinct EF phenotypes have been poorly investigated in elderly patients aged ≥70 y. Accordingly, the present study aimed at assessing the clinical and echocardiographic characteristics of a retrospective cohort of elderly HFpEF patients (aged ≥ 70 y), categorized on the basis of "normal" EF (50 to 64%) or "supra-normal" EF (≥65%).
View Article and Find Full Text PDFJ Cardiovasc Dev Dis
December 2024
Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
Transcatheter aortic valve replacement (TAVR) in patients with severe aortic stenosis and raphe-type bicuspid aortic valve (BAV) is still associated with poor outcomes in terms of increased risk of paravalvular regurgitation, stroke, and permanent pacemaker implantation. There is no definitive consensus on the optimal sizing method for prosthesis selection in this setting. The LIRA method is a supra-annular tailored sizing method specifically designed for bicuspid anatomy that might increase accuracy of prosthesis choice in BAV patients and improve TAVR outcomes.
View Article and Find Full Text PDFCatheter Cardiovasc Interv
January 2025
Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
Background: The long-term valve durability of supra-annular self-expanding valves (SEV) and intra-annular balloon-expandable valves (BEV) in patients with small aortic annuli remains unexplored.
Aims: This study aimed to determine the long-term bioprosthetic valve durability with SEV versus BEV in patients with small aortic annuli.
Methods: This retrospective study included patients with severe aortic stenosis (AS) and an aortic annulus area of 430 mm or less who underwent transcatheter aortic valve replacement using SEV and BEV between October 2009 and December 2022.
Cureus
November 2024
Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN.
We report a 75-year-old female with a history of two heart operations: aortic valve replacement (St. Jude Medical 21 mm) at the age of 44 years for severe rheumatic aortic stenosis and mitral valve replacement (Carbomedics 29 mm) at the age of 51 years for rheumatic mitral regurgitation. Decades later, she presented with exertional dyspnea.
View Article and Find Full Text PDFCatheter Cardiovasc Interv
December 2024
Center of Innovative Interventions in Cardiology, University Hospital Bonn, Bonn, Germany.
Background: The self-expanding, supra-annular Evolut valve is an established platform for Transcatheter Aortic Valve Implantation (TAVI). Evolut PRO introduced an outer sealing wrap to mitigate paravalvular leakage. We evaluated the 3-year clinical outcomes and valve performance of the Evolut PRO in standard clinical practice for severe aortic stenosis (AS) patients at intermediate or higher risk for surgery.
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