The utilization of bioprostheses in valve surgcry has been limited by the restrictive hemodynamics and suboptimal durability of porcine valves. The hemodynamic problems have been solved by the Carpentier Edwards pericardial bioprostheses.

We implanted 57 Carpentier-Edwards pericardial bioprostheses in 50 patients at our clinic between February 2 and September 9,1994. There were 13 aortic, 38 mitral and 9 double valve replacements. Double valve replacement was mitral-aortic in all. The age range was 14 to 75 years old, with a mean age of 39.7 (SD: 14) years. 68% (34) of the patients were women. Preoperatively, 88% of the patients were in NYHA class III or IV. Mortality rate was 2% (1 patient). Anticoagulant-related hemorrhage occured in 1(2%) patient. Early complications were atelectasia in 4(8%), bleeding revision in 2(4%), hemiplegia in 1(2%), complet A-Vblock in 1(2%) and pleural effusion in 3(6%) patients. Pre operative characteristics of patients were atri al fibrilation in 31 (62%), LA thrombus in 9, history of thromboemboli in 2, history of closed mitral valvoto my (mean 13.2 years ago) in 9 and, severe pulmonary hypertension in 12(24%) patients. Left auricular ligation in 28% of patients, LA thombectomy in 9, LA plication in 8 patients were done as concomittant procedures. There were no reoperation, endocarditis, hemolysis, thromboembolic events and valve-related complications. Echocardiographic studies were done in 38 (77.5%) patients with CE pericardial bioprosthe sis after a mean of öne month, postoperatively. The mean aortic gradient averaged 9.47 mmHg (SD:0.7Û), an average mitral pressure gradient of 5.13 (SD: 0.68) mmHg has been obtained.

We believe that the Carpentier-Edwards pericardial bioprostheses, with their the better hemodynamic characteristics and the lower structural deterioration rates, among stented bioprostheses, are suitable val ves when the need for a bioprosthesis is indicated.