Pathologic findings in 74 dysfunctional Braile-Biomédica bovine pericardial heart valves recovered at reoperation, 1978 to 1990.
This report describes the morphological data obtained from 74 Braile-Biomédica bovine pericardial valves (previously named IMC bovine pericardial valve) recovered at reoperation in our institution between 1978 and 1990. This retrospective analysis allowed for a thorough evaluation of the pathologic findings after long-term implantation of the Braile-Biomédica pericardial xenograft. The major cause of valve failure was pericardial tissue calcification, causing cuspal stiffening or structural defect responsible for clinical symptoms of stenosis and/or regurgitation. Our results demonstrated calcification in 65% of the explanted bioprostheses. Calcific deposits were most extensive in the tunica fibrosa of the pericardium, more prevalent in patients less than 30 years old at the time of implantation, and in valves implanted in the mitral position. Mild to moderate degenerative changes of the native pericardium were observed. No differences between men and women could be detected. Endocarditis was the second most frequent cause of xenograft failure (16%). Cuspal tears, contrasting with previous reports on the pathological features in clinically failed pericardial valves, were relatively infrequent (6.8%). Two valves explanted (2.7%) because clinical manifestation of valvular incompetence showed marked degenerative changes of the pericardial native tissue as the only findings. These observations, very similar to those reported for porcine aortic valves, complement and give support to previously published data on the satisfactory clinical performance of the Braile-Biomédica pericardial bioprosthesis. The discrepancy between the present observations and those reported by other authors on different types of pericardial valves, reinforces the opinion that these pericardial bioprostheses should not be studied as an unified group, the results and conclusions must be specific for each one of them.
Suzigan
S
S
Faculty of Medicine of São José do Rio Preto, São Paulo, Brazil.
Braile
D M
DM
Souza
D R
DR
Rossi
M A
MA
D000293:Adolescent; D000328:Adult; D000368:Aged; D001705:Bioprosthesis; D002114:Calcinosis / Q000473:pathology; D002648:Child; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies