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The Journal of Thoracic and Cardiovascular Surgery, Vol 94, 20-33, Copyright © 1987 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Comparative analysis of mechanical and bioprosthetic valves after aortic valve replacement

AM Borkon, LM Soule, KL Baughman, H Aoun, WA Baumgartner, TJ Gardner, L Watkins Jr, VL Gott and BA Reitz

Comparative long-term performance characteristics of Bjork-Shiley mechanical and bioprosthetic valves were analyzed for patients undergoing aortic valve replacement between 1976 and 1981. A total of 419 patients received either a standard Bjork-Shiley (n = 266) or bioprosthetic (porcine, n = 126, or pericardial, n = 27) aortic valve. Cumulative patient follow-up was 1,705 patient-years; the average patient follow-up was 4.1 +/- 2.7 years. Survival data were obtained for all but 11 patients (97% complete follow-up) up to 9 years after operation. Survival at 5 years was 81% +/- 4% (+/- standard error) for Bjork-Shiley and for bioprosthetic valve recipients. Valve failure in the Bjork-Shiley group was predominantly due to valve-related mortality and did not result from structural failure. Patients with bioprosthetic valves experienced valve failure as a result of prosthetic valve endocarditis and intrinsic valve degeneration. Although patients with bioprostheses experienced a lower incidence of valve-related morbidity than Bjork-Shiley valve recipients (p less than 0.03), no difference could be demonstrated in the incidence of valve-related mortality or valve failure at 5 years between bioprosthetic and Bjork-Shiley valves. Mortality rate from valve failure was higher for Bjork-Shiley (86%, 12/14) than bioprosthetic valves (36%, 5/14) (p less than 0.01).

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