Life of the Carpentier Edwards Perimount Valve

[Simon Booker]

I'd be grateful for views on the longevity of this valve - Edwards suggest on their web-site that this is good for 20 years plus, and that current versions eliminate calcium binding - hence affording a greater lifespan. However, here in the UK, the health authorities suggest that this valve only has a 50% chance of functioning beyond 15 years. It may be that here in the UK, we are a little out of date, but this is an important choice. My father is 62 and needs AVR shortly.

Grateful for views on this.

 

[Lynlw]

The last study I saw was from 2003 (on the Older model) and it showed 90% of patients over 60 did not need a replacement at 20 years (I can't find the actually study right now, it was posted before) but here is the article http://www.edwards.com/newsroom/nr20030502.htm

Edwards Announces 20-Year Durability Data for PERIMOUNT Aortic Valve

New Data Reinforce Pericardial Aortic Valve's Long-Term Performance

IRVINE, Calif., May 2 -- Edwards Lifesciences Corporation (NYSE: EW), a global leader in medical technologies to treat advanced cardiovascular disease, announced today that it has completed a 20 year follow-up on the effectiveness and durability of its leading aortic pericardial tissue heart valve.

The data indicate that patients 60 years and older who receive a Carpentier-Edwards PERIMOUNT aortic valve will have a greater than 90% chance of not needing a new valve for 20 years. ..."


That was 5 years ago, so I don't know if there will be a 25 year report.

 

[escargome]

Hi Simon,
As of May 19, 2008 I became the proud owner of a brand spanking new Edwards LifeScience Bovine Pericardial Heart Valve. My surgeon told me that I could expect about 20 years use out of it. He also said that since he is not God he could not be more specific. I was 56 at the time and after doing research on both biological vs mechanical, my heart and gut told me to chose biological. My surgeon and I agreed that by the time this valve ceases being useful the cardiac medical community will be doing valve replacements much like an angioplasty is done today. I have faith that this will be true. So I don't know how much help this will be to you, but do as much research as you need until you feel comfortable with whatever decisions you, your dad and his cardiologist make. Good Luck to you.

 

[ALCapshaw2]

The fact that your father is over 60 puts him in the group that can expect the longest service from a Tissue Valve. The 'new and improved' Bovine Pericardial Tissue Valves are *hoped* to outlast the original version which does have a good track record at 20 years for older patients.

If his parents lived into their 90's, he may want to consider the On-X mechanical valve with it's lower risk of clot formation (and possible recommendation for lower levels of anticoagulation upon completion of current studies in another 6? years)

Either choice is a GOOD CHOICE. The Only Bad Choice would be to NOT get his defective valve replaced.

'AL Capshaw'

 

[Jkm7]

My surgeon told me basically the same thing Escargome wrote above.
He expects an excellent chance my bovine Edwards Perimount in Mitral position could well last 20+ years. He also said he fully expects by then, there will be far less cracking chests open and valve replacements will be done percutaneously.

I had my valve replaced February, 2008.

 

[Simon Booker]

Type of Edwards valve?

Type of Edwards valve?

Thanks very much for your advice. It seems that the Carpentier-Edwards PERIMOUNT Theon or Magna aortic valves offer good longevity (90% at 20 years). Are these regarded as the best valves to go for?

I'll also look into the on-X mechanical valve as my father's concern is his sensitivity to anticoagulants and ultimately risk of stroke. This may be unfounded from what I have read on this site, although going for a mechanical valve type that reduces the dependency on anticoagulants seems attractive.

One other question that occurs to me reading the responses to this thread is whether having a valve replaced means that in future years when medical technology has moved on - it may not be possible to have keyhole surgery? My understanding of keyhole currently is that the deseased valve is simply pushed into the heart wall and the new valve secured behind it. Could it be that you can't push an old prosthetic valve into the heart in this way? Alternatively - maybe someone will think of a way around this over the next 20 years!

Thanks once again for your views. I am extremely grateful.

 

[escargome]

One other question that occurs to me reading the responses to this thread is whether having a valve replaced means that in future years when medical technology has moved on - it may not be possible to have keyhole surgery? My understanding of keyhole currently is that the deseased valve is simply pushed into the heart wall and the new valve secured behind it. Could it be that you can't push an old prosthetic valve into the heart in this way? Alternatively - maybe someone will think of a way around this over the next 20 years!

Thanks once again for your views. I am extremely grateful.

Simon,
I truly haven't looked into the hows and wherefores of keyhole surgery, but having a bovine valve that will likely need to be replaced around the time I'm 76 or so, I have decided that I will burn that bridge when I get to it. I'm having too much fun living my life right now.

 

[Lynlw]

I am not sure BUT I think you are talking about 2 different things when you say Keyhole. I think you are talking about percutaneuos valve replacement where they do everything in the cath lab thru your groin. But generally keyhole surgery is the min invasive surgery where they use a couple of small holes and use robotics (someone her posted there davinci pictures) like when you get your gall bladder out.here is an example http://www.hi-europe.info/files/2004/9959.htm
In the cath replaced replacement the old valve IS squished, BUT right now in the pulmonary valve trials they are replacing tissue valves, the squish it like they would your native valve. BUT you are right they can't replace mechanical valves that way.

 

[Lynlw]

I'd be grateful for views on the longevity of this valve - Edwards suggest on their web-site that this is good for 20 years plus, and that current versions eliminate calcium binding - hence affording a greater lifespan. However, here in the UK, the health authorities suggest that this valve only has a 50% chance of functioning beyond 15 years. It may be that here in the UK, we are a little out of date, but this is an important choice. My father is 62 and needs AVR shortly.

Grateful for views on this.

I'm curious was the UK about patients over 60 or everyone that has a CE Bovine? The reason I ask is IF they are counting all people young people really drag the numbers down, partly because younger people naturally go thru the tissue faster, BUT another thing they rarley mention is alot of kids get their valves replaced a couple times before they reach adult, NOT because of a breakdown of the valve, but because they out grow it and need a bigger one.

 

[nickd]

Hi Simon,

I'm going on Wednesday to have my aortic valve replaced with the Edwards bovine valve, I'm 37 and my surgeon feels that I should get 12 years out of it, give or take. What was encouraging and also talked about was on this forum is replacing the valves through a heart cath. Again, my surgeon told me that it will probably be done this way by time I need to get mine replaced. Your father should do well if that is his valve choice, good luck with the decision.

Nick

 

[Simon Booker]

Valve selection

Valve selection

Thanks for your help. I think we have arrived at a choice - the Perimount successor: the Magna-Ease. This seems to have excellent results and looks to be the preferred biological valve of a couple of surgeons that I've discussed with - with low re-operation rates over 20 years.

 

[Simon Booker]

Good luck with your surgery Nick

Good luck with your surgery Nick

I'm really encouraged that you are having the Edwards valve at 37 - seems that the long term prospects for this valve are great and as you say, when the time comes for replacement, minimally invasive approaches may well be the norm. Best of luck

 

[needinfo]

Keyhole surgery

Keyhole surgery

I asked about minimally invasive surgery for AVR. My surgeon says its possible, but he feels the risk of him having "limited access" is like changing a piston through the oil cap. If something happens you have to spend valuable time to tear it down, and the recovery is pretty much the same. I am sure this is his opinion and the one I am entrusting my life to.

 

[luvsgod]

Simon,

I had an Edwards Bovine 11/07 and within 10 months it was leaking severely. Now I need another replacement. This time I will go with a mechanical.

 

[escargome]

Simon,

I had an Edwards Bovine 11/07 and within 10 months it was leaking severely. Now I need another replacement. This time I will go with a mechanical.

Hi Luvsgod,
Did the leak happen at the valve itself or the stitching around it?