Seven year experience with mounted porcine valves

Area of Science:

• Cardiovascular Surgery
• Biomaterials Science
• Medical Devices

Background:

• Porcine aortic xenografts have been utilized for cardiac valve replacement since the late 1960s.
• Long-term follow-up data is crucial for evaluating the durability and efficacy of bioprosthetic heart valves.
• Early preservation methods, such as formalin, presented challenges with long-term valve function.

Purpose of the Study:

• To evaluate the long-term outcomes of porcine aortic xenograft valve replacement.
• To compare the performance of formalin-preserved versus glutaraldehyde-preserved porcine valves.
• To assess the safety and hemodynamic efficacy of these bioprosthetic valves.

Main Methods:

• Retrospective analysis of 108 porcine aortic xenograft valves implanted in 95 patients between 1969 and 1976.
• Comparison of valve failure rates, reoperation requirements, and embolic/thrombotic complications between formalin and glutaraldehyde preservation methods.
• Assessment of hemodynamic performance through late cardiac catheterization.

Main Results:

• Hospital mortality was not influenced by the type of porcine valve used.
• Formalin-preserved valves showed a high rate of failure requiring reoperation (all but four patients).
• Glutaraldehyde-preserved valves exhibited significantly lower failure rates (two instances) with no embolic or thrombotic complications. Hemodynamic results were comparable or superior to prosthetic valves.

Conclusions:

• Glutaraldehyde preservation significantly improves the long-term durability and safety of porcine aortic xenograft valves.
• Porcine xenografts, particularly those preserved with glutaraldehyde, represent a preferred choice for cardiac valve replacement.
• Long-term follow-up confirms the clinical efficacy and hemodynamic benefits of glutaraldehyde-preserved porcine bioprosthetic valves.