Lyn, I'm not sure why you wrote
When I said the leading valves were good, I was talking about the ones around over 25 years, the same ones I was talking about this entire thread.
Those are also the ones I'm talking about. And I think the biggest and best studies show that some of those good valves last longer than others. It used to be "standard wisdom" that cow valves lasted longer than pig valves, even though both were "good" and in common use for decades. I believe the newest and best studies (including the "Gold Standard" study on my valve from my hospital) shows the opposite, that the Hancock II has been lasting quite a bit longer than the CEP.
You also wrote
As for the "gold standard study" that (I think they said they had good results for the oldest age group?) as I said earlier, beside reading a study with a few hundred people, . . .
I think you know that the "Gold Standard" study (details above) documented 1134 patients, all of whom got the Hancock II. That's not "a few hundred people" where I come from, but maybe we'll have to agree to disagree on that, too. Many of the other studies discussed in that article, mostly on the Hancock II and the CEP valves, also dealt with >1000 patients receiving identical valves. The comparisons are pretty strong statistically, as you can see from the "+/-" numbers, which represent the bounds of the 95% confidence intervals -- which also suggests that the studies don't suffer from small sample sizes.
Here's one sample comparison:
McClure and colleagues [16] recently published the long-term outcomes of 1000 patients who had AVR with the CEP. . . . According to Figure 2 in their article, . . . they reported a freedom from reoperation due to SVD at 15 years of 34.7% in patients younger than 65 years and 89.4% in patients aged 65 to 75. The freedom from SVD with the Hancock II at 15 years was 80.7% +/- 2.6% for patients younger than 65 and 99.0% +/- 4.2% for patients aged 65 and older.[emphasis added]
"[16]" refers to a 2010 Ann. Thorac. Surg article entitled "Late outcomes for aortic valve replacment with the Carpentier-Edwards peicardial bioprosthesis: up to 17-year follow-up in 1,000 patents."
As I've discussed before, freedom from REOPERATION for significant valve deterioration (SVD) is always higher than freedom from SVD, because the former misleadingly includes patients who HAVE SVD, but aren't fit candidates for surgery. So this large advantage of the HII over the CEP is in fact UNDER-stated, by that difference.
While the authors only claim "Gold Standard" status in patients 60 and over (you refer to "the oldest age group", as if the other results were unimpressive), they may be too modest, since their 80.7% freedom from SVD after 15 years in the <65 age group seems heads and shoulders above the CEP's 34.7% freedom
from reoperation due to SVD at 15 years in the same age group. Again, nobody is denying that the CEP is a good tissue valve, and a long-time standard in the US. But I don't think we should be denigrating any of our fellow patients who do decide to exert some effort to try to join an 80.7%-odds group instead of a less-than-34.7% group, or to try for 99% odds instead of 89.4%.
The other studies cited in the "Gold Standard" study, on those two valves and a few others, seem to fall into about the same pattern.