Twenty-Year Experience With the St. Jude Medical Biocor Bioprosthesis in the Aortic Position

Background The purpose of this study was to evaluate the long-term performance of the St. Jude Medical Biocor stented porcine prosthesis in the aortic position. Methods From January 1985 to December 1996, 455 patients admitted for aortic valve replacement were consecutively enrolled in this study. The mean age was 72.5 ± 9 years, 18 patients (3.5%) had had previous cardiac surgery, and coronary artery bypass grafting was performed in 171 patients (37.6%). Follow-up was complete in 99.6%; up to 21 years were covered. Actuarial event-free rates are given as mean ± standard error and adverse events were classified according to the guidelines for reporting morbidity and mortality after cardiac valvular operations. Results Cumulative follow-up time was 3,321 patient-years with a mean follow-up of 8.2 years. The actuarial survival rate after 20 years was 9.4% ± 2.8%. The actuarial rates for freedom from structural valve deterioration were 93.1% ± 1.7% at 10 years, 88.4% ± 3.5% at 15 years, and 70.3% ± 10.9% at 20 years. The actuarial rates for freedom from reoperation due to structural valve deterioration were 91.9% ± 1.6% at 10 years, 90.6% ± 2.1% at 15 years, and 86.5% ± 4.5% at 20 years. Conclusions This study presents one of the largest series of St. Jude Medical Biocor aortic valves in the world. Results indicate an age-dependent risk of structural valve degeneration beginning as soon as 7 years postoperatively for patients below the age of 65 years, but show a low overall incidence of valve-related complications and excellent durability.