Fifteen-year experience with the mitral Carpentier-Edwards PERIMOUNT pericardial bioprosthesis

Background. This multicenter study concerning the mitral PERIMOUNT valve previously reported clinical results at 12 years; this report updates the performance to 15 years postoperatively. Methods. The 435 patients (mean age 60.7 +/- 11.6 years; 41.1% male) underwent implantation with the PERIMOUNT valve between 1984 and 1989 at seven institutions. Follow-up was complete for 96.1% of the cohort. The mean follow-up was 8.1 +/- 4.4 years (range 0 to 15.4 years) for a total of 3492 patient-years. Results. There were 34 (7.8%) operative deaths, one (0.2%) valve related. The late mortality rate was 5.3%/patient-year (2.2%/patient-year valve related). At 14 years, the overall actuarial survival rate was 37.1% +/- 3.3% (63.1% +/- 4.4% valve related). Actuarial freedom from complications at 14 years was as follows: thromboembolism, 83.8% +/- 3.2% (1.1%/patient-year); hemorrhage, 86.6% +/- 3.2% (1.1%/patient-year); and explant due to structural valve deterioration (SVD), 68.8% +/- 4.7%. Actual freedom from explant due to SVD was 83.4% +/- 2.3%. Rates of structural failure decreased with increasing age at implant. Conclusions. The Carpentier-Edwards PERIMOUNT Pericardial Bioprosthesis is a reliable choice for a tissue valve in the mitral position, especially in patients more than 60 years of age. (C) 2001 by The Society of Thoracic Surgeons.