[Investigation of primary tissue failure in mitral bioprostheses]

A study was conducted on 118 Hancock (HX) porcine valves, 251 Carpentier-Edwards (CE) porcine valves, and the biological valves in children used in the mitral position. Twenty-three HX valves, twenty-seven CE valves, and all valves except one operative death in children were diagnosed as primary tissue failure (PTF). Freedom from PTF for HX valves was 70.1 +/- 6.0% at ten years and for CE valves was 45.7 +/- 17.0% at ten years, although for children it was calculated 0% at eight years (significantly poor results compared with adults). No relation was found between the degree of calcified cusps and the duration of PTF valves used. The ruptures and calcifications of the cusps were most commonly observed in commissure. The peeled off commissures were characteristic in CE valves. Three adults and two children died without reoperation caused by calcified stenotic valves. Since the risk of reoperation was higher in NYHA functional class four, we recommend earlier elective reoperation.