Nine Years Experience with 1287 Carpentier-Edwards® Porcine Bioprostheses
The durability and functional results of porcine prosthetic valves remain controversial. In order to assess these parameters, 1287 porcine prosthetic valve insertions from January 1977 through September 1986 were reviewed. There were 523 mitral (MVR), 518 aortic (AVR), 238 combined AVR + MVR, and 8 tricuspid (TVR) implants. The average age was 59 years. The malefemale ratio was 68%:32%. The majority of patients were in New York Heart Association (NYHA) Class III or IV preoperatively. Rheumatic or calcific valvulitis was present in 78%, myxomatous degeneration in 10%, and infective endocarditis in 12%. Valve replacement was performed utilizing moderate hypothermia (22 °G) and cold blood cardioplegia (10 °C). The operative mortality for MVR was 2.8% (14/523), for AVR was 1.8% (19/518), for AVR 4- MVR was 4.8% (11/238), and 0% for TVR (0/8). Thromboembolic events occurred in 7 MVR patients (1.3%), 5 AVR patients (1%), and 4 combined AVR/MVR patients (4%). Primary valve failure occurred in 20 MVR (3%) and 18 AVR cases (2%). Endocarditis has occurred in 15 patients (1.1%). Gated scans (6 to 12 months postoperative) have shown stable or improved left ventricular function. Endo cardiograms (1 to 9 years postoperative) demonstrated excellent valve function in 90% of the patients. Survival at 9 years has been 85% from all causes and 92% from cardiac deaths. These results support continued use of the porcine prosthetic valve in valvular heart disease.
KeywordsValve Replacement Infective Endocarditis Prosthetic Valve Mitral Valve Replacement Heart Valve Replacement
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