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J Thorac Cardiovasc Surg 2009;137:76-81
© 2009 The American Association for Thoracic Surgery

Acquired Cardiovascular Disease

A 20-year experience of 1712 patients with the Biocor porcine bioprosthesis

^a Department of Thoracic and Cardiovascular Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
^b Department of Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden

Received for publication October 29, 2007; revisions received April 23, 2008; accepted for publication May 28, 2008.

^_* Address for reprints: Pia S. U. Mykén, MD, PhD, Department of Thoracic and Cardiovascular Surgery, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden. (Email: pia.myken{at}swipnet.se).

Objective: The 20-year data from the ongoing long-term study of the St Jude Medical Biocor (St Jude Medical, St Paul, Minn) porcine bioprosthesis are reported. Earlier follow-ups have shown that the valve has excellent durability. After 20 years, will this continue to be true?

Methods: Data were obtained for 1712 patients who underwent valve replacement (1518 aortic valve replacements; 194 mitral valve replacements) with glutaraldehyde-preserved Biocor bioprostheses at Sahlgrenska University Hospital (Sweden) between 1983 and 2003. Follow-up after surgery was evaluated on alternate years using hospital records, interviews, and questionnaires.

Results: At 20 years, the cumulative follow-up was 8843 and 1195 patient-years for aortic valve replacement and mitral valve replacement, respectively. Survival after aortic valve replacement was 17.7% ± 3.3%, and survival after mitral valve replacement was 16.4% ± 4.7%. Actuarial freedom from reoperation because of structural valve deterioration was 61.1% ± 8.5% and 79.3% ± 6.0% after aortic valve replacement and mitral valve replacement, respectively. (The equivalent actual/cumulative values were 85.6% ± 2.2% and 91.2% ± 2.6%, respectively.) In aortic valve recipients aged 65 years or less and more than 65 years, actuarial freedom from reoperation because of structural valve deterioration was 44.5% ± 9.2% and 92.1% ± 3.9%, respectively. The equivalent values in mitral valve recipients were 75.2% ± 7.6% and 88.0% ± 8.1%, respectively.

Conclusion: The 20-year data confirm the excellent valve durability reported at the 17-year follow-up after both aortic valve replacement and mitral valve replacement using the Biocor porcine bioprosthesis.

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