Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-26T10:29:21.808Z Has data issue: false hasContentIssue false
  • English
  • Français

EFFICACY OF CARPENTIER-EDWARDS PERICARDIAL PROSTHESES: A SYSTEMATIC REVIEW AND META-ANALYSIS

Published online by Cambridge University Press:  20 May 2015

Carlos Alberto S. Magliano ,
Roberto M. Saraiva ,
Vitor Manuel P. Azevedo ,
Adriana M. Innocenzi ,
Bernardo R. Tura  and
Marisa Santos
Carlos Alberto S. Magliano
Affiliation:
Instituto Nacional de [email protected]
Roberto M. Saraiva
Affiliation:
Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz
Vitor Manuel P. Azevedo
Affiliation:
Instituto Nacional de Cardiologia
Adriana M. Innocenzi
Affiliation:
Instituto Nacional de Cardiologia
Bernardo R. Tura
Affiliation:
Instituto Nacional de Cardiologia
Marisa Santos
Affiliation:
Instituto Nacional de Cardiologia
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: The Carpentier-Edwards pericardial (CEP) prostheses are the type of bioprostheses most used worldwide. Although they were designed to minimize the rate of valve deterioration and reoperation, their clinical superiority over other prostheses models still lacks confirmation. The objective of this study was to evaluate its effectiveness.

Methods: We performed a systematic review and meta-analysis in the PubMed, Embase, Cochrane, and Lilacs databases. Operative mortality, overall mortality and reoperation rates after heart valve surgery were compared between the use of CEP and other cardiac prostheses. Two independent reviewers screened studies for inclusion and extracted the data. Disagreements were resolved by consensus. The GRADE criterion was used to assess the evidence quality.

Results: A total of twenty-eight studies were selected, including 19,615 individuals. The studies presented a high heterogeneity and low quality of evidence what limited the reliability of the results. The pooled data from the selected studies did not demonstrate significant differences between CEP and porcine, pericardial or stentless prostheses regarding operative mortality, overall mortality and reoperation rates. However, the pooled data from 3 observational trials pointed out a higher risk for reoperation after valve replacement using CEP prostheses against mechanical prostheses (OR 4.92 [95 percent confidence interval 2.43–9.96]).

Conclusions: The current data present in the literature still does not support a clinical advantage for the use of CEP prostheses over other bioprostheses. The quality of the studies in the literature is limited and further studies are needed to address if CEP prostheses will have a clinical advantage over other prostheses.

Keywords

Carpentier-Edwards prosthesesBioprosthesesSystematic reviewMeta-analysis
Type
Assessments
Information
International Journal of Technology Assessment in Health Care , Volume 31 , Issue 1-2 , 2015 , pp. 19 - 26
Copyright
Copyright © Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. Arinaga, K, Fukunaga, S, Tomoeda, H, et al. Twelve-year experience with the Carpentier-Edwards pericardial aortic valve at a single Japanese center. Artif Organs. 2011;14:209–214.Google Scholar
2. Puvimanasinghe, JP, Takkenberg, JJ, Eijkemans, MJ, et al. Prognosis after aortic valve replacement with the Carpentier-Edwards pericardial valve: Use of microsimulation. Ann Thorac Surg. 2005;80:825–831.Google Scholar
3. Higgins, JP, Thompson, SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21:1539–1558.Google Scholar
4. Guyatt, GH, Oxman, AD, Vist, GE, et al. GRADE: An emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336:924–926.Google Scholar
5. Risteski, PS, Martens, S, Rouhollahpour, A, et al. Prospective randomized evaluation of stentless vs. stented aortic biologic prosthetic valves in the elderly at five years. Interact Cardiovasc Thorac Surg. 2009;8:449–453.CrossRefGoogle ScholarPubMed
6. Cohen, G, Zagorski, B, Christakis, GT, et al. Are stentless valves hemodynamically superior to stented valves? Long-term follow-up of a randomized trial comparing Carpentier-Edwards pericardial valve with the Toronto Stentless Porcine Valve. J Thorac Cardiovasc Surg. 2010;139:848–859.Google Scholar
7. Chambers, JB, Rimington, HM, Hodson, F, Rajani, R, Blauth, CI. The subcoronary Toronto stentless versus supra-annular Perimount stented replacement aortic valve: Early clinical and hemodynamic results of a randomized comparison in 160 patients. J Thorac Cardiovasc Surg. 2006;131:878–882.Google Scholar
8. Stassano, P, Di Tommaso, L, Monaco, M, et al. Aortic valve replacement: A prospective randomized evaluation of mechanical versus biological valves in patients ages 55 to 70 years. J Am Coll Cardiol. 2009;54:1862–1868.Google Scholar
9. Borger, MA, Carson, SM, Ivanov, J, et al. Stentless aortic valves are hemodynamically superior to stented valves during mid-term follow-up: A large retrospective study. Ann Thorac Surg. 2005;80:2180–2185.Google Scholar
10. Le Tourneau, T, Savoye, C, McFadden, EP, et al. Mid-term comparative follow-up after aortic valve replacement with Carpentier-Edwards and Pericarbon pericardial prostheses. Circulation. 1999;100:11–16.Google Scholar
11. Badhwar, V, Ofenloch, JC, Rovin, JD, van Gelder, HM, Jacobs, JP. Noninferiority of closely monitored mechanical valves to bioprostheses overshadowed by early mortality benefit in younger patients. Ann Thorac Surg. 2012;93:748–753.Google Scholar
12. Brown, ML, Schaff, HV, Lahr, BD, et al. Aortic valve replacement in patients aged 50 to 70 years: Improved outcome with mechanical versus biologic prostheses. J Thorac Cardiovasc Surg. 2008;135:878–884.Google Scholar
13. Carrier, M, Pellerin, M, Perrault, LP, et al. Aortic valve replacement with mechanical and biologic prosthesis in middle-aged patients. Ann Thorac Surg. 2001;71:253–256.Google Scholar
14. Weber, A, Noureddine, H, Englberger, L, et al. Ten-year comparison of pericardial tissue valves versus mechanical prostheses for aortic valve replacement in patients younger than 60 years of age. J Thorac Cardiovasc Surg. 2012;144:1075–1083.Google Scholar
15. Sakamoto, Y, Hashimoto, K, Okuyama, H, et al. Carpentier-Edwards pericardial aortic valve in middle-aged patients: Comparison with the St. Jude Medical valve. Jpn J Thorac Cardiovasc Surg. 2005;53:465–469.CrossRefGoogle ScholarPubMed
16. Accola, KD, Scott, ML, Palmer, GJ, et al. Surgical management of aortic valve disease in the elderly: A retrospective comparative study of valve choice using propensity score analysis. J Heart Valve Dis. 2008;17:355–364.Google Scholar
17. Forcillo, J, Pellerin, M, Perrault, LP, et al. Carpentier-Edwards pericardial valve in the aortic position: 25-years experience. Ann Thorac Surg. 2013;96:486–493.Google Scholar
18. Frater, RW, Salomon, NW, Rainer, WG, Cosgrove, DM III, Wickham, E. The Carpentier-Edwards pericardial aortic valve: Intermediate results. Ann Thorac Surg. 1992;53:764–771.Google Scholar
19. Ayegnon, KG, Aupart, M, Bourguignon, T, et al. A 25-year experience with Carpentier-Edwards Perimount in the mitral position. Asian Cardiovasc Thorac Ann. 2011;19:14–19.Google Scholar
20. Banbury, MK, Cosgrove, DM III, Lytle, BW, et al. Long-term results of the Carpentier-Edwards pericardial aortic valve: A 12-year follow-up. Ann Thorac Surg. 1998;66:73–76.Google Scholar
21. Marchand, MA, Aupart, MR, Norton, R, et al. Fifteen-year experience with the mitral Carpentier-Edwards PERIMOUNT pericardial bioprosthesis. Ann Thorac Surg. 2001;71:236–239.Google Scholar
22. Pellerin, M, Mihaileanu, S, Couetil, JP, et al. Carpentier-Edwards pericardial bioprosthesis in aortic position: Long-term follow-up 1980 to 1994. Ann Thorac Surg. 1995;60:292–295.Google Scholar
23. Torka, MC, Salefsky, BE, Hacker, RW. Intermediate clinical results after aortic valve replacement with the Carpentier-Edwards pericardial bioprosthesis. Ann Thorac Surg. 1995;60:311–315.Google Scholar
24. Neville, PH, Aupart, MR, Diemont, FF, et al. Carpentier-Edwards pericardial bioprosthesis in aortic or mitral position: A 12-year experience. Ann Thorac Surg. 1998;66:143–147.Google Scholar
25. Dellgren, G, David, TE, Raanani, E, et al. Late hemodynamic and clinical outcomes of aortic valve replacement with the Carpentier-Edwards Perimount pericardial bioprosthesis. J Thorac Cardiovasc Surg. 2002;124:146–154.Google Scholar
26. Poirer, NC, Pelletier, LC, Pellerin, M, Carrier, M. 15-year experience with the Carpentier-Edwards pericardial bioprosthesis. Ann Thorac Surg. 1998;66:57–61.Google Scholar
27. Jamieson, WR, Germann, E, Aupart, MR, et al. 15-year comparison of supra-annular porcine and PERIMOUNT aortic bioprostheses. Asian Cardiovasc Thorac Ann. 2006;14:200–205.Google Scholar
28. Chan, V, Kulik, A, Tran, A, et al. Long-term clinical and hemodynamic performance of the Hancock II versus the Perimount aortic bioprostheses. Circulation. 2010;122:10–16.Google Scholar
29. Le Tourneau, T, Vincentelli, A, Fayad, G, et al. Ten-year echocardiographic and clinical follow-up of aortic Carpentier-Edwards pericardial and supraannular prosthesis: A case-match study. Ann Thorac Surg. 2002;74:2010–2015.Google Scholar
30. Gao, G, Wu, Y, Grunkemeier, GL, Furnary, AP, Starr, A. Durability of pericardial versus porcine aortic valves. J Am Coll Cardiol. 2004;44:384–388.Google Scholar
31. Khan, SS, Trento, A, DeRobertis, M, et al. Twenty-year comparison of tissue and mechanical valve replacement. J Thorac Cardiovasc Surg. 2001;122:257–269.Google Scholar
32. Cohn, LH, Collins, JJ, Rizzo, RJ, et al. Twenty-year follow-up of the Hancock modified orifice porcine aortic valve. Ann Thorac Surg. 1998;66:30–34.Google Scholar
33. Bacelar, AC, Lopes, AS, Fernandes, JR, et al. Brazilian guidelines for valve disease - SBC2011/I guideline inter-American valve disease. Arq Bras Cardiol. 2011;97:1–67.Google Scholar
Supplementary material: File

Magliano supplementary material

Table S1

Download Magliano supplementary material(File)
File 29.9 KB
Supplementary material: File

Magliano supplementary material

Table S2

Download Magliano supplementary material(File)
File 15.5 KB