<![CDATA[St Jude Medical-Biocor bovine pericardial bioprosthesis: long-term survival]]>

Abstract

The objective of this work is to present longterm results of valve replacement using SJM-Biocor TM bovine pericardial bioprostheses. Methods: From 1992 to 2000, 304 patients were discharged from hospital after bioprosthesis implantation. Ages ranged from 15 to 83 years (mean: 60.6 ± ± ± ± ± 14.3 years) and 50.3% were male. Patient deaths and events related to bioprosthesis (infection, thromboembolism and structural failure) were considered for estimation of cumulative probability of survival and event-free survival. Results: Total follow-up was 931.0 patients-year. During follow-up there were 28 (9.2%) deaths. Causes were bioprosthesis failure in five (1.6%), cardiac in seven (2.3%), non-cardiac in four (1.3%), and unknown in 12 (3.9%) patients. Events related to bioprosthesis were: endocarditis: 18 (5.9%), fibrocalcific degeneration: 15 (4.9%), thromboembolism: three (1.0%), hemolysis: one (0.3%). Bioprosthesis dysfunctions resulted in 16 (5.2%) reoperations due to fibrocalcific degeneration (nine), endocarditis (six) and thromboembolism (one). Probability of survival was higher in the young population (< 40 years, n=35) when compared to the older group (> 60 year, n=187): 82.0 ± ± ± ± ± 13.3% vs. 58.8 ± ± ± ± ± 13.6% in the 9 th year. Event-free survival was 77.5 ± ± ± ± ± 3.7% for 5 th year and 40.2 ± ± ± ± ± 9.0% for 10 th year. Overall estimative of structural failure for a SJM-Biocor TM was 5% in 5 th year increasing to 20% in the 10 th year. In the aortic position the values were zero and 8%, respectively. Considering current clinical conditions, 88.5% are in NYHA class I, 9.1% in class II and 2.3% in class III. Conclusions: SJM-Biocor TM bovine pericardial bioprostheses resulted in satisfactory survival of patients, related to low prevalence of bioprosthesis dysfunction. Descriptors: Bioprosthesis. Heart valve prosthesis. Heart valves. Resumo Objetivo: Nosso objetivo é apresentar resultados a longo prazo da subsituição valvar por bioprótese de pericárdio bovino SJM-Biocor TM. Método: Entre 1992 e 2000, tiveram alta hospitalar, após substituição valvar por bioprótese de pericárdio bovino SJM-Biocor TM 304 pacientes. Idades eram de 15 a 83 anos (média: 60,6± ± ± ± ±14,3), sendo 50,3% do sexo masculino. Pacientes tiveram situação clínica atualizada e análise atuarial foi empregada no cálculo da sobrevida simples e livre de eventos.

Late outcome analysis of the Braile Biomédica® pericardial valve in the aortic position

“…Being a tertiary center with great experience in bioprosthesis implantation [ 6 , 7 ] and in reoperations [ 16 , 17 ] , there is a high incidence of previous cardiac surgeries, historically rising - from 1980 to 1999, 22.8% were reoperations [ 16 ] and, from 2006 to 2010, 27.5% were reoperations. This incidence is only comparable to Bacco et al [ 15 ] , that, with 25.6% incidence of reoperations, found 15% in-hospital mortality for aortic valve replacement. Despite mortality higher than data from the United States and the United Kingdom [ 18 , 19 ] , it is worth mentioning the need of pairing mortality to surgical risk [ 8 , 9 , 20 ] and of internal validation of the risk score models.…”

“…We found freedom from structural dysfunction of 98.57±0.70% at 5 years, comparable to the Carpentier-Edwards prosthesis [ 21 ] at 98±0.2% and superior to the St Jude Biocor [ 15 ] at 89.2±3.5%, and a linearized rate of 0.075% patients-year.…”

“…In-hospital mortality was 8.16%, compared to national reports of 8% [ 13 ] mortality for general cardiac surgery and from 7.0 to 15.0% for aortic valve replacement [ 14 , 15 ] , not adjusted. Being a tertiary center with great experience in bioprosthesis implantation [ 6 , 7 ] and in reoperations [ 16 , 17 ] , there is a high incidence of previous cardiac surgeries, historically rising - from 1980 to 1999, 22.8% were reoperations [ 16 ] and, from 2006 to 2010, 27.5% were reoperations.…”

Insuficiência aórtica aguda por avulsão de comissura valvar aórtica

“…Despite the small number of cases reported in the literature, some authors suggest that aortic valve replacement would be the best choice, considering the poor long-term results while preserving the valve in this context [4], compared to the consistent results of aortic valve replacement by bovine pericardium bioprosthesis [5,6]. However, there are reports showing acceptable results using the repair and preservation of the valve [7], although the safety of this technique is not known.…”