title: Ten year experience with Aspire (Tissuemed) porcine bioprosthesis: single centre experience.
abstract: BACKGROUND
  Aspire (Tissuemed) bioprosthesis is a third generation porcine bioprosthesis. 10-year outcome of this bioprosthesis is unknown.
  
  
  METHODS
  We report our experience of 139 consecutive prosthesis implanted between 1990-1998. The clinical outcome was reviewed retrospectively.
  
  
  RESULTS
  126 patients (67 males and 59 females), mean age 68.4+/-8.4 years underwent 139 valve replacements. Sites of valve implantation included the aortic in 77 patients (61%); mitral in 35 patients (27%); aortic+mitral in 13 patients (10%) and tricuspid in 1 patient (0.8%). 32/126 patients (25%) also underwent concomitant coronary artery bypass grafting (CABG). 30-day mortality for the whole group was 8.7% (11/126) with no valve related deaths. Follow up was 98.4% complete with a mean follow up of 6.1+/-3.3 years (766 patient-years, range 0-10.2 years). Overall 10-year actuarial survival was 41+/-7% (AVR 49+/-10%, MVR 29+/-11%) and this was influenced by pre-operative poor left ventricular function (EF<30%) (p=0.007) and pre-operative NYHA class III/IV (p=0.001). Overall estimated 10-year actuarial freedom from valve related events (Kaplan-Meier) and valve related events expressed as linearised rates (%/patient-year) were: freedom from structural valve failure 97+/-2% (0.26%/patient-year); non-structural dysfunction 98+/-1% (0.13%/patient-year); freedom from prosthetic valve endocarditis 94+/-3% (0.39%/patient-year); freedom from significant haemorrhagic event 82+/-6% (1.33%/patient-year); freedom from thrombo-embolism 90+/-3% (0.91%/patient-year) and freedom from re-operation was 93+/-3% (0.52%/patient-year).
  
  
  CONCLUSIONS
  In our experience Aspire (Tissuemed) porcine bioprosthesis functions satisfactorily at 10-years with low valve related complications. Further follow-up will determine its long-term durability.
authors.affiliation: Department of Cardiothoracic Surgery, St Bartholomew's Hospital, London, UK. pankajkumar66@hotmail.com
authors.forename: P
authors.initials: P
authors.lastname: Kumar
authors.forename: T
authors.initials: T
authors.lastname: Athanasiou
authors.forename: S
authors.initials: S
authors.lastname: Mussa
authors.forename: A J
authors.initials: AJ
authors.lastname: Wood
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001705:Bioprosthesis; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000601:surgery*; D006350:Heart Valve Prosthesis / Q000009:adverse effects; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011475:Prosthesis Failure; D012086:Reoperation; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome