We analyzed the intermediate experience, survival, and prosthetic complications of patients who received the Biocor valve, a new-generation porcine valve, in the mitral position. At the University of Padua, between Ma...We analyzed the intermediate experience, survival, and prosthetic complications of patients who received the Biocor valve, a new-generation porcine valve, in the mitral position. At the University of Padua, between May 1992 and January 2004, 154 consecutive patients(102 female and 52 male patients; mean age, 72.3±6 years; age range, 37-86 years) received 158 mitral Biocor prostheses(Biocor Industria e Pesguisa Ltda, Belo Horizonte, Brazil). Thirty-five percent of the patients had previous mitral operations, 24%had coronary artery bypass grafting, and 34.6%had other procedures. Median preoperative New York Heart Association class was III. Echocardiography was performed in 75%of the long-term survivors. Follow-up included 609.4 patient-years and was 100%complete, with a median time of 4 patient-years(range, 0.02-11.3 years). At 8 years, 20(14%) of 142 operative survivors were still at risk. Early mortality was 13.6%. According to univariate analysis, New York Heart Association class III to IV, ejection fraction of less than 40%, urgency, male sex, and coronary artery bypass grafting were significant perioperative risk factors. Eight-and 10-year actuarial survival was 51.1%±5.6%(40 deaths). Eight-year actuarial freedom from valve-related death, thromboembolism, anticoagulant-related hemorrhage, endocarditis, paravalvular leak, and valve-related complications were 85.2%±5%, 85.7%±4.4%, 92.6%±3.7%, 94.1%±3%, 91.8%±3%, and 70.2%±5.7%, respectively. Freedom from structural valve deterioration was 100%. Actual freedom from reoperation was 93.2%±2.2%. By Doppler echocardiography, the peak and mean transprosthetic gradients were 15±5 mm Hg and 6.3±3 mm Hg, respectively(mean follow-up, 4.2±2.7 years). At intermediate follow-up, the Biocor prosthesis in the mitral position showed excellent results in terms of valve durability when compared with other second-generation tissue valves.展开更多
文摘We analyzed the intermediate experience, survival, and prosthetic complications of patients who received the Biocor valve, a new-generation porcine valve, in the mitral position. At the University of Padua, between May 1992 and January 2004, 154 consecutive patients(102 female and 52 male patients; mean age, 72.3±6 years; age range, 37-86 years) received 158 mitral Biocor prostheses(Biocor Industria e Pesguisa Ltda, Belo Horizonte, Brazil). Thirty-five percent of the patients had previous mitral operations, 24%had coronary artery bypass grafting, and 34.6%had other procedures. Median preoperative New York Heart Association class was III. Echocardiography was performed in 75%of the long-term survivors. Follow-up included 609.4 patient-years and was 100%complete, with a median time of 4 patient-years(range, 0.02-11.3 years). At 8 years, 20(14%) of 142 operative survivors were still at risk. Early mortality was 13.6%. According to univariate analysis, New York Heart Association class III to IV, ejection fraction of less than 40%, urgency, male sex, and coronary artery bypass grafting were significant perioperative risk factors. Eight-and 10-year actuarial survival was 51.1%±5.6%(40 deaths). Eight-year actuarial freedom from valve-related death, thromboembolism, anticoagulant-related hemorrhage, endocarditis, paravalvular leak, and valve-related complications were 85.2%±5%, 85.7%±4.4%, 92.6%±3.7%, 94.1%±3%, 91.8%±3%, and 70.2%±5.7%, respectively. Freedom from structural valve deterioration was 100%. Actual freedom from reoperation was 93.2%±2.2%. By Doppler echocardiography, the peak and mean transprosthetic gradients were 15±5 mm Hg and 6.3±3 mm Hg, respectively(mean follow-up, 4.2±2.7 years). At intermediate follow-up, the Biocor prosthesis in the mitral position showed excellent results in terms of valve durability when compared with other second-generation tissue valves.
