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Original Articles: Adult Cardiac

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

Department of Cardiovascular Surgery, German Heart Center Munich, Munich, Germany

Accepted for publication May 21, 2008.

^_* Address correspondence to Dr Eichinger, Department of Cardiovascular Surgery, German Heart Center Munich, Lazarettstr. 36, Munich, 80636, Germany (Email: eichinger{at}dhm.mhn.de).

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.

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