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J Thorac Cardiovasc Surg 1998;116:599-608
© 1998 Mosby, Inc.

SURGERY FOR ADULT CARDIOVASCULAR DISEASE

LONG-TERM DOPPLER ECHOCARDIOGRAPHIC RESULTS OF AORTIC OR MITRAL VALVE REPLACEMENT WITH BIOCOR PORCINE BIOPROSTHESIS

Göteborg, Sweden

The Biocor pericardial valve, formerly the trademark of Biocor Industria e Pesquisas Ltd, Belo Horizonte, Brazil, was acquired in 1996 by St Jude Medical, Inc, St Paul, Minn.

Received for publication July 18, 1997. Revisions requested Oct 1, 1997; revisions received May 20, 1998. Accepted for publication June 22, 1998. Address for reprints: Kenneth Caidahl, MD, PhD, Department of Clinical Physiology, Sahlgrenska University Hospital, S-413 45 Göteborg, Sweden.

Objectives: Our objectives were to evaluate the long-term bioprosthetic and cardiac functional outcome after insertion (over a 10-year period) of a new-generation porcine zero pressure–fixed Biocor bioprosthesis, as well as to determine the echocardiographic accuracy for selection of patients requiring reoperation. The long-term systematic Doppler echocardiographic assessment after valve replacement with this bioprosthesis is lacking.
Methods: Between January 1983 and January 1993, we inserted 756 Biocor prostheses in the aortic (619) or mitral (137) positions. All 51 patients who had a reoperation during the follow-up time were evaluated echocardiographically before reoperation. Additionally, 263 of 446 patients (59%) with aortic bioprostheses and 42 of 74 patients (57%) with mitral bioprostheses who were alive in January 1993 had long-term echocardiographic follow-up.
Results: Group A: Normally functioning bioprostheses were found in the aortic position in 242 of 263 patients and in the mitral position in 33 of 42 patients. Group B: Thirty patients had abnormal bioprosthetic function. Eleven patients had regurgitation, 3 had a combined lesion, and signs of calcification appeared in 16 patients with aortic valves, all with a peak gradient of above 60 mm Hg. Group C: Patients who had a reoperation (41 aortic and 10 mitral) within the follow-up period were followed up echocardiographically from the detection of a possible valve dysfunction until reoperation, and the findings accorded well with those at operation in 49 of 51 patients.
Conclusions: These findings suggest that, during a long-term follow-up, most bioprostheses function normally, facilitating improved heart function. Abnormalities in a bioprosthesis usually develop gradually, enabling their detection by Doppler echocardiographic evaluations performed regularly or in case of any symptomatic deterioration.

This article has been cited by other articles:

				K. Kirali, M. Guler, A. Tuncer, B. Daglar, G. Ipek, O. Isik, and C. Yakut Fifteen-year clinical experience with the Biocor porcine bioprostheses in the mitral position Ann. Thorac. Surg., March 1, 2001; 71(3): 811 - 815. [Abstract] [Full Text] [PDF]