title: [Long-term results of porcine bioprosthetic heterograft; a 13-years' experience].
abstract: One hundred and ninety-four patients underwent valve replacements with the glutaraldehyde-preserved porcine bioprostheses (133 Hancock valves, 39 Angell-Shiley valves, 22 Carpentier-Edwards valves and 3 other valves) from 1974 through 1979. There were 105 women and 89 men, whose age ranged 18 to 62 (mean 38.8) years. One hundred and eighty-two patients had mitral bioprosthetic valve replacement (BVR)s, of which 52 had combined aortic mechanical valve replacements, 8 had aortic BVR's, 3 had tricuspid BVR's and 3 had multi-BVR's. Operative mortality was 10.8%. Only one patient was lost to follow-up. Cumulative duration of follow-up is 1421 patient-years. Linearized rate of anticoagulant related hemorrhage, thromboembolism (TE), prosthetic valve endocarditis (PVE), primary tissue failure (PTF) and valve dysfunction (VD) were 0.07, 1.62, 0.49, 2.74 and 3.66% per patient-year. Actuarial freedom from TE, PVE, PTF and VD were 87.0 +/- 2.7%, 95.6 +/- 1.5%, 65.2 +/- 4.9% and 56.9 +/- 5.6% at 13 years. Actuarial survival rate was 67.4 +/- 4.0% at 13 years. Long term follow-up after valve replacement with porcine bioprosthetic valve confirms low thrombogenicity. But primary tissue failure was the chief cause of valve dysfunction and represent a major problem. At this time, we are going to use porcine bioprosthetic valve in the selected patients, that is in the situations in which anticoagulation is contraindicated.
authors.affiliation: Department of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical College, Japan.
authors.forename: K A
authors.initials: KA
authors.lastname: Sawatani
authors.forename: K
authors.initials: K
authors.lastname: Nakano
authors.forename: E
authors.initials: E
authors.lastname: Imamura
authors.forename: M
authors.initials: M
authors.lastname: Endo
authors.forename: A
authors.initials: A
authors.lastname: Hashimoto
authors.forename: H
authors.initials: H
authors.lastname: Hayashi
authors.forename: H
authors.initials: H
authors.lastname: Koyanagi
mesh_terms: D000293:Adolescent; D000328:Adult; D001021:Aortic Valve; D001705:Bioprosthesis / Q000009:adverse effects; D004696:Endocarditis / Q000209:etiology; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve; D011475:Prosthesis Failure; D013923:Thromboembolism / Q000209:etiology; D014261:Tricuspid Valve