[The PB IMC bovine pericardial prosthesis: 11 years in the mitral position. Instituto de Moléstias Cardiovasculares].
OBJECTIVE
To evaluate the postoperative results of patients with valvular bovine pericardium prosthesis in mitral position.


METHODS
From 1977 to 1988, 10.812 bovine pericardial valves were produced by IMC Biomédica and implanted. Our group at IMC implanted 1,193. Of the 663 patients with mitral change, 586 were adults and 77 were youngsters (under 21). The rheumatic fever was the most frequent primary cause of valvar disease (76.5%). The stenosis (23.0%) and the insufficiency (20.7%) were the most common of the damages that led to mitral exchange. We studied 602 patients that left the hospital, representing 666 bioprostheses in 11 years. The surgeries were performed with standard cardiopulmonary bypass with crystalloid cardioplegia in the first seven years and hypothermic or normothermic blood cardioplegia enriched with amino acids in the last four years.


RESULTS
Hospital mortality was 9.2%; 13.2% for the first 5.5 years (group I) and 6.3% for the last 5.5 years (group II). Eleven-year follow-up was 98.8% and the mean time was 3.8 years. The actuarial study showed a survival rate of 74.3 +/- 6.5% for the youngsters and 73.0 +/- 3.7% for the adults, with 95.0 +/- 1.0% of the patients free from valve-related fatal complications corresponding to one event % patient-years (endocarditis 0.6%; calcification 0.1%; thromboembolism 0.3%). The actuarial rate of non fatal valve-related late complications was 55.2 +/- 8.6% of patients free from all complications, corresponding an incidence of 2.9%/patient-year (endocarditis 0.5%; calcification 1.8%; thromboembolism 0.3%; periprosthetic leakage 0.2% and rupture 0.08%). In this period 95.8 +/- 1.6% of the patients were free from thromboembolism; 99.1 +/- 0.6% free from rupture; 90.1 +/- 4.08% free from endocarditis in the young group (1.5%/patient-year) and 95.2 +/- 1.03% for adults (1.0%/patient-year). For calcification, the actuarial rate was 43.1 +/- 12.3% for youngsters (7.5/patient-year) and 68.8 +/- 9.3% for adults (1.1%/patient-year).


CONCLUSIONS
IMC pericardial bioprosthesis performed well in a period of 11 years with low rates of fatal complications; ruptures and thromboembolism without the use of anticoagulants. Calcification was the major complication mainly in youngsters.
Braile
D M
DM
Zaiantchick
M
M
Souza
D R
DR
D000293:Adolescent; D000328:Adult; D001705:Bioprosthesis / Q000009:adverse effects / Q000706:statistics & numerical data; D001938:Brazil / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000150:complications / Q000401:mortality / Q000601:surgery; D006350:Heart Valve Prosthesis / Q000009:adverse effects / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008943:Mitral Valve; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012214:Rheumatic Heart Disease / Q000150:complications / Q000401:mortality / Q000601:surgery
Prótese de pericárdio bovino PB IMC: 11 anos em posição mitral.