Aortic xenograft valve performance at eight years. A comparative study.
The medium-term performance of commercially available xenograft prostheses in the aortic position, was evaluated in 198 patients operated upon since 1975. No associated procedures were performed in these patients in whom a variety of prostheses was employed. The valve behaviour has been compared with other xenograft series, homografts and synthetic prostheses. There was a 5.5% hospital death rate and a 7.5% late mortality. Five late deaths were valve related, five were unrelated to the valve and four were of unknown cause but in elderly patients. At eight years, 86.1% of patients were alive, the majority functionally improved. Thromboembolic events were considerably fewer than those experienced with most non-biological prostheses, all but three events being transient. Re-operation for primary valve dysfunction was a safe procedure but re-operation for infected prostheses carried a high mortality. In comparing the aortic xenograft with other prostheses, severe dysfunction was found to occur with similar frequency in all prostheses up to eight years and was rare. Mild prosthetic dysfunction (asymptomatic diastolic murmur) occurs in about 25% of all tissue valves at eight years, including the homograft. The progression, or otherwise, of mild dysfunction has yet to be evaluated in currently available xenograft prostheses.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D001705:Bioprosthesis; D002648:Child; D002675:Child, Preschool; D005069:Evaluation Studies as Topic; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis / Q000401:mortality; D006801:Humans; D007223:Infant; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012086:Reoperation