Long Term Outcomes and Durability of Bioprosthetic Valve for Valve Replacement at Siriraj Hospital

Abstract

Objective: Bioprosthesis has been used in cardiac valve replacement for a long time. However, structural valve deterioration is still a major cause of failure. There are several risk factors for valve deterioration. This study evaluates the risk factors of valve deterioration in the long term (10 years) at Siriraj Hospital.Materials and Methods: We retrospectively reviewed the medical records of 249 patients who underwent mitral or aortic valve replacement between January 2006 and December 2012 using various tissue valves, comprising Carpentier–Edwards porcine, Carpentier–Edwards Perimount bovine pericardial, Carpentier–Edwards Perimount Magna bovine pericardial, and St Jude Trifecta bovine pericardial types. The information from each patient was entered into a database at the time of the operation and followed up regularly, with a mean follow-up of 10 years.Results: After 10 years follow-up time, the incidence of valve deterioration events were 1.2% and 8.43% in the first five and ten years, respectively. The overall death rate during follow-up was 2.41%. There were three statistically significant risk factors (p < 0.05) of valve deterioration: gender (female) (p = 0.042), age ≤ 60 years old (p = 0.010) and St Jude Trifecta bovine pericardial valve (p = 0.004).Conclusion: In the surgical populations who underwent valve replacement at Siriraj Hospital with tissue valves, we found an acceptable long-term durability of the tissue valve. The risk factors of valve deterioration were female gender, age ≤ 60 years old, and St Jude Trifecta bovine pericardial valve.