Long-term performance of porcine heart valve bioprostheses

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Abstract
To assess the results after long-term implantation of porcinebioprosthetic heart valves, 320 patients with 381 valves wereretrospectively reviewed. This group included all patients receiving onesuch xenograft in the mitral or aortic position (or both) in ourinstitution between June 1974 and December 1976. The patients had afollow-up of 9-11.5 years. Actuarial patient survival rats (hospitalmortality excluded) were 85%-90% at 6 years and 68%-79% at 11.5 years.Thromboembolic episodes did not show any significant clustering over thefirst weeks or months, in fact, they appeared at a constant rate. Actuarialrates of freedom from thromboembolism were greater than 90% for aorticpatients at 11.5 years and greater than 80% for mitral and mitroaorticpatients at 11.5 years. The linearized rate of anticoagulant-relatedhaemorrhage for the whole group of patients was 0.4 events/100 patientyears with a related mortality of 0.2 events/100 patient years. Prostheticvalve endocarditis and paravalvular leak appeared at linearized rates of0.6 (0.1 of related mortality) and 0.4 (0.1 of related mortality)events/100 patient years. Primary tissue valve failure constituted the mostprevalent complication (82 cases) in the long term but did notsignificantly worsen patient survival. Actuarial rates of freedom fromprimary tissue failure were 91% +/- 2% at 6, and 40% +/- 14% at 11.5 yearsfor mitral valves, and 95% +/- 4% at 6 and 64% +/- 6% at 11.5 years foraortic valves.(ABSTRACT TRUNCATED AT 250 WORDS)

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