Fifteen years follow up with the St. Jude Medical Biocor porcine bioprosthesis.
OBJECTIVE
The study aim was to review the 15-year results of aortic (AVR) and mitral (MVR) valve replacement with the St. Jude Medical Biocor porcine prosthesis, in order to investigate long-term survival and valve-related complications.


METHODS
Between January 1983 and January 1998, a total of 1,187 patients underwent either AVR (n = 1,029; mean age 69 years) or MVR (n = 158; mean age 63 years). Follow up (99.7% complete) was monitored in 1998, and all data were analyzed with regard to actuarial valve failure rates. Long-term echocardiographic data were obtained.


RESULTS
Cumulative follow up time was 5,049 patient-years (pt-yr) for AVR patients, and 845 pt-yr for MVR patients. Actuarial survival rate at 15 years was 41 +/- 3%, and freedom from valve-related death was 94 +/- 1% for the AVR group; corresponding values for the MVR group were 25 +/- 11% and 84 +/- 6%. The occurrence of structural valve deterioration (SVD) varied with age; older patients were less affected. Freedom from SVD was 76 +/- 7% and 92 +/- 4% for AVR and MVR patients, respectively. Thromboembolism (TE) occurred mainly among the oldest patients, and was most prevalent among those with MVR. Actuarial freedom from TE was 82 +/- 5% after AVR and 75 +/- 7% after MVR. Prosthetic valve endocarditis (PVE) was rare, but caused the only reoperative mortality. Freedom from PVE was 95 +/- 2% after AVR and 93 +/- 3% after MVR.


CONCLUSIONS
Although the optimal valve substitute remains to be found, this long-term study of a third-generation bioprosthesis showed a low incidence of valve-related complications, especially of valve deterioration. This type of bioprosthesis appears to be more durable than valves of previous generations.
Mykén
P
P
Department of Thoracic and Cardiovascular Surgery, Sahlgrenska University Hospital, Göteborg, Sweden.
Bech-Hanssen
O
O
Phipps
B
B
Caidahl
K
K
D000206:Actuarial Analysis; D000368:Aged; D000818:Animals; D001021:Aortic Valve; D001705:Bioprosthesis; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000601:surgery; D006350:Heart Valve Prosthesis / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve; D011183:Postoperative Complications / Q000453:epidemiology; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation / Q000706:statistics & numerical data; D013552:Swine; D013997:Time Factors