Aortic xenograft valve performance at eight years. A comparative study.

Area of Science:

• Cardiovascular Surgery
• Biomaterials Science

Background:

• Xenograft prostheses are widely used for aortic valve replacement.
• Evaluating their long-term efficacy and safety is crucial for clinical practice.

Purpose of the Study:

• To assess the medium-term performance of commercial xenograft prostheses in the aortic position.
• To compare xenograft valve behavior with other prosthetic types.

Main Methods:

• Retrospective evaluation of 198 patients who received aortic xenograft prostheses since 1975.
• Analysis of hospital and late mortality, functional status, thromboembolic events, and valve dysfunction.

Main Results:

• Hospital death rate was 5.5%, with a 7.5% late mortality. 86.1% of patients were alive at eight years, with most showing functional improvement.
• Thromboembolic events were infrequent and mostly transient. Re-operation for dysfunction was safe, but for infection carried high mortality.
• Severe valve dysfunction occurred rarely and with similar frequency across all prostheses up to eight years. Mild dysfunction was observed in 25% of tissue valves.

Conclusions:

• Aortic xenograft prostheses offer acceptable medium-term performance with a low rate of severe dysfunction.
• Mild dysfunction is common in tissue valves, and its progression requires further investigation.
• While re-operation for primary dysfunction is safe, prosthetic infection poses a significant risk.