Fifteen-year clinical experience with the Biocor porcine bioprostheses in the mitral position

Background. Bioprosthetic valve use represents a crucial improvement in surgical treatment of mitral valve disease. The aim of this study is to determine the long-term durability of the Biocor porcine bioprosthetic mitral valve. Methods. Between 1985 and 1989, a total of 158 Biocor porcine bioprosthetic valves were placed in the mitral position, and long-term results of these patients were investigated retrospectively in 1999. Results. Thirty-day mortality was 4.4% (7 patients). Total follow-up was 1,499 patient-years. Actuarial survival was 83.66% ± 3% at 5 years, 77.78% ± 3.36% at 13 years (1.8% patient-year). Multivariate analysis demonstrated younger age, duration of implantation, congestive heart failure, and functional class to be significant predictors of late mortality. Actuarial freedom from valve-related mortality was 98.58% ± 1% at 15 years (0.13% patient-year). Actuarial freedom from structural valve deterioration was 95.49% ± 1.8% at 5 years, 70.2% ± 4.12% at 10 years, and 64.82% ± 5.34% at 13 years (2.6% patient-year). Actuarial freedom from structural valve deterioration-related reoperation was 98.43% ± 1.1% at 5 years, 89.15% ± 2.85% at 10 years, and 76.82% ± 7.91% at 14 years. Multivariate analysis showed younger age and duration of implantation to be significant predictors of structural valve deterioration and its related reoperation. Conclusions. By studying a 15-year time period, it is seen that this new generation porcine bioprosthetic valve should be considered an alternative for mechanical valves in selected patients.