European Journal of Cardio-Thoracic Surgery, Vol 2, 273-281, Copyright © 1988 by European Association for Cardio-thoracic Surgery
Long-term performance of porcine heart valve bioprostheses
I Gallo, F Nistal, R Cayon, E Arbe, R Blasquez and E Artinano
Department of Cardiovascular Surgery, Hospital Nacional Marques de Valdecilla, University of Cantabria, Santander, Spain.
To assess the results after long-term implantation of porcine bioprosthetic
heart valves, 320 patients with 381 valves were retrospectively reviewed.
This group included all patients receiving one such xenograft in the mitral
or aortic position (or both) in our institution between June 1974 and
December 1976. The patients had a follow-up of 9-11.5 years. Actuarial
patient survival rats (hospital mortality excluded) were 85%-90% at 6 years
and 68%-79% at 11.5 years. Thromboembolic episodes did not show any
significant clustering over the first weeks or months, in fact, they
appeared at a constant rate. Actuarial rates of freedom from
thromboembolism were greater than 90% for aortic patients at 11.5 years and
greater than 80% for mitral and mitroaortic patients at 11.5 years. The
linearized rate of anticoagulant-related haemorrhage for the whole group of
patients was 0.4 events/100 patient years with a related mortality of 0.2
events/100 patient years. Prosthetic valve endocarditis and paravalvular
leak appeared at linearized rates of 0.6 (0.1 of related mortality) and 0.4
(0.1 of related mortality) events/100 patient years. Primary tissue valve
failure constituted the most prevalent complication (82 cases) in the long
term but did not significantly worsen patient survival. Actuarial rates of
freedom from primary tissue failure were 91% +/- 2% at 6, and 40% +/- 14%
at 11.5 years for mitral valves, and 95% +/- 4% at 6 and 64% +/- 6% at 11.5
years for aortic valves.(ABSTRACT TRUNCATED AT 250 WORDS)
