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J Thorac Cardiovasc Surg 2005;129:322-329
© 2005 The American Association for Thoracic Surgery

Surgery for Acquired Cardiovascular Disease

Intermediate results of isolated mitral valve replacement with a Biocor porcine valve

^a Department of Cardiovascular Surgery, University of Padua Medical School, Padua, Italy
^b Department of Pathology, University of Padua Medical School, Padua, Italy

Received for publication January 10, 2004; revisions received June 11, 2004; accepted for publication June 21, 2004.

^* Address for reprints: Gino Gerosa, MD, Department of Cardiovascular Surgery, Via Giustiniani, 2, 35128, Padova, Italy (E-mail: gino.gerosa{at}unipd.it).

BACKGROUND: 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.

METHODS: 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.

RESULTS: 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).

CONCLUSION: 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.

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