[Bioprosthetic valvular dysfunction in mitral position: three cases of commissural detachment]

Three cases of commissural detachment in Carpentier-Edwards (C-E) porcine xenografts are reported. All patients had undergone mitral valve replacement (MVR) with C-E porcine xenograft for rheumatic mitral valvular disease 6 to 10 years ago and developed congestive heart failure gradually that required replacement of C-E porcine xenograft. The removed C-E porcine xenografts showed commissural detachments and showed no cusp teaps or cusp perforations. On the basis of the results of our 120 patients with porcine xenograft in the mitral position, we emphasize that the incidence of prosthetic valve dysfunction due to primary tissue failure increases rapidly after the sixth postoperative year.