Between July 1984 and December 1993. 110 patients, younger than 60 years, underwent aortic valve replacement with a Carpentier-Edwards pericardial valve. 75.5% were male, with a mean age of 49.6 years (range: 16 to 59 years). Mean clinical status was 2.25. Operative mortality was 0%. All patients but 3 were followed up with a total follow-up of 454 patient-years and an average of 4.8 years. The 10-year actuarial survival is 91 +/- 6%. We observed 8 valve-related complications (1.7% patient-years): 3 cases of endocarditis, 3 structural failures, 1 thromboembolic event, and 1 perivalvular leak. 1 patient died from a valve-related cause, and 2 reoperations were necessary. The 8-year actuarial probability of absence of valve-related death is 99 +/- 1%, thromboembolism 98 +/- 2%, endocarditis 96 +/- 4%; reoperations 96 +/- 4%, and valve failure 97 +/- 3%. The 10-year valve-related complication rate is satisfactory, but the durability of the prosthesis in this group of young patients remains unknown. A longer follow-up is mandatory to draw definitive conclusions.