J.Jpn. Surg. Soc.. 89(11): 1886-1892, 1988

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Original article

LONG-TERM RESULTS OF PORCINE BIOPROSTHETIC HETEROGRAFT ; A 13-YEAR EXPERIENCE

One hundred and ninty-four patients underwent valve replacements with the glutaraldehydepreserved porcine bioprostheses (133 Hancock valves, 39 Angell-Shiley valves, 22 Carpentier-Edwards valves and 3 other valves) from 1974 through 1979. There were 105 women and 89 men, whose age ranged 18 to 62 (mean 38.8) years. One hundred and eighty-two patients had mitral bioprosthetic valve replacement (BVR)s, of which 52 had combined aortic mechanical valve replacements, 8 had aortic BVR's, 3 had tricuspid BVR's and 3 had multi-BVR's. Operative mortality was 10.8%.
Only one patient was lost to follow-Up. Cumulative duration of follow-Up is 1421 patient-years. Linearized rate of anticoagulant related hemorrhage, thromboembolism (TE), prosthetic valve endocarditis (PVE), primary tissue failure (PTF) and valve dysfunction (VD) were 0.07, 1.62, 0.49, 2.74 and 3.66% per patient-year. Actuarial freedom from TE, PVE, PTF and VD were 87.0±2.7%, 95.6±1.5%, 65.2±4.9% and 56.9±5.6% at 13 years. Actuarial survival rate was 67.4±4.0% at 13 years. Long term follow-up after valve replacement with porcine bioprosthetic valve confirms low thrombogenesity. But primary tissue failure was the chief cause of valve dysfunction and represent a major problem. At this time,we are going to use porcine bioprosthetic valve in the selected patients, that is in the situations in which anticoagultion is contraindicated.

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