{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T06:48:49Z","timestamp":1781765329115,"version":"3.54.5"},"reference-count":0,"publisher":"IMR Press","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["HSF"],"abstract":"<jats:p>Background: The elderly population is growing at an unprecedented rate. Aortic valve disease increases with age. Bioprostheses are the valves of choice for older patients; however, the optimal tissue valve remains undetermined. The purpose of this investigation was to perform a life-of-patient survival comparison of the prototypical porcine and pericardial prostheses in elderly patients. Methods: The study population (N = 1480) consisted of patients 65 years of age and older who underwent isolated aortic valve replacement from 1990 through 2005 with a Carpentier-Edwards Porcine (n = 650) or Pericardial (n = 830) bioprosthesis. Propensity score-matched groups were created. Results: Valve selection was not associated with operative mortality. Survival estimates at 10 years were better for Pericardial (41.8%; 95% CI: 37.9 to 45.7) than Porcine (32.6%; 95% CI: 28.8 to 36.3); and 5.2% (95% CI: 3.2 to 7.1) versus 2.0%; (95% CI: 0.8 to 3.2) at 20 years (p &lt; 0.001). E-value analysis found minimal influence of unknown study confounders. Factors associated with long-term mortality were porcine valve (p &lt; 0.001), age (p &lt; 0.001), diabetes mellitus (p &lt; 0.001), preop renal insufficiency (p &lt; 0.001), peripheral artery disease (p = 0.011), congestive heart failure (p = 0.003), New York Heart Association Class III or IV (p = 0.004), surgical history-reoperation (p = 0.012), transient ischemic attack (p = 0.009), prolonged ventilation (p = 0.010), postop renal insufficiency (p &lt; 0.001), and atrial fibrillation (p = 0.009). The indexed Effective Orifice Area (EOAi) was assessed and did not influence observed long-term survival differences. Conclusions: This unusual lifetime study provided substantial evidence for the superiority of the pericardial over the porcine bioprosthesis in the aortic position in elderly patients. It demonstrated enhanced long-term survival benefits for elderly patients without any increase in perioperative mortality. It is intended to inform future investigation into aortic valve design.<\/jats:p>","DOI":"10.59958\/hsf.6917","type":"journal-article","created":{"date-parts":[[2023,12,29]],"date-time":"2023-12-29T00:56:23Z","timestamp":1703811383000},"page":"E869-E879","source":"Crossref","is-referenced-by-count":1,"title":["Long-Term Survival Benefits of Porcine versus Pericardial Bioprostheses in Elderly Patients Undergoing Isolated Aortic Valve Replacement: A 32-Year Study"],"prefix":"10.31083","volume":"26","author":[{"given":"George","family":"Ebra","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernest A.","family":"Traad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul A.","family":"Kurlansky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16242","published-online":{"date-parts":[[2023,12,27]]},"container-title":["The Heart Surgery Forum"],"original-title":[],"link":[{"URL":"https:\/\/journal.hsforum.com\/index.php\/HSF\/article\/download\/6917\/8617","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journal.hsforum.com\/index.php\/HSF\/article\/download\/6917\/8617","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T08:41:05Z","timestamp":1760690465000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.imrpress.com\/journal\/HSF\/26\/6\/10.59958\/hsf.6917"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,27]]},"references-count":0,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2023,11,6]]}},"URL":"https:\/\/doi.org\/10.59958\/hsf.6917","relation":{},"ISSN":["1522-6662","1098-3511"],"issn-type":[{"value":"1522-6662","type":"electronic"},{"value":"1098-3511","type":"print"}],"subject":[],"published":{"date-parts":[[2023,12,27]]}}}