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Ann Thorac Surg 1997;64:293-294
© 1997 The Society of Thoracic Surgeons

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Correspondence

Supplement: Proceedings of the VI International Symposium on Cardiac Bioprostheses

Guest Co-Editor,Supplement: VI Interrnational Symposium on Cardia ioprostheses, Department of Surgery, University of British Columbia, 3100-910 W 10th Ave, Vancouver, Bc V5z 4e3, Canada.

To the Editor:

There have been concerns raised about information published in the 1995 Supplement. The only published concern, to my knowledge, was in the September 1996 issue of The Annals. As guest co-editor of the Supplement I will take this opportunity to comment on all three articles.

Medtronic Intact Porcine Bioprosthesis

In the September issue of The Annals, Dr Herwig Antretter [1] expressed concern over the citation [2] discussing the hydrodynamic performance of porcine bioprostheses. The citation was indeed incorrect and should have been "Vesely I. Analysis of the Medtronic Intact bioprosthetic valve. J Thorac Cardiovasc Surg 1991;101:90–9" [3]. The article by Lemieux and colleagues [4] reported satisfactory performance of the Medtronic Intact porcine bioprosthesis at 5 and 7 years. Doctor Antretter reported an explanted prosthesis with a large jagged hole at 43 days after implantation [1]. Doctor Antretter cited a similar case reported by Haverich and co-authors [5]. The three-center Canadian experience with the Medtronic Intact porcine bioprosthesis has been further evaluated and the freedom from structural failure remains satisfactory at 8 to 9 years (unpublished, submitted to the VII International Symposium on Cardiac Bioprostheses).

Carpentier-Edwards Pericardial Bioprosthesis in the Aortic Position

The article by Pellerin and colleagues [6] reported freedom from reoperation due to structural valve deterioration was 100% at 12 years and 83% at 13 years with an explanted prosthesis with structural failure. In the published discussion I quoted a stated freedom from structural valve deterioration of 91% at 10 years. The understanding was that structural failure was observed but the patients had not come to reoperation. I confirmed this concept with the manufacturer, Baxter Healthcare Corporation. The information obtained was 93.2% ± 3.5% freedom from structural valve deterioration at 12 years.

Carpentier-Edwards Standard and Supraannular Porcine Bioprostheses

The article by Jamieson and colleagues [7] compared the performance of the Carpentier-Edwards standard and supraannular porcine bioprostheses. The article also evaluated the supraannular bioprosthesis with censoring of the structural failure due to strut dehiscence. The failure mode of strut dehiscence was considered due to extensive trimming of the aortic wall during the manufacturing process. The manufacturing process was changed during the years 1986 and 1987 to reduced trimming of the aortic wall. It has been learned the programming for calculation of the data presented produced some extraneous data on freedom from structural valve deterioration for mitral and multiple replacements with and without strut dehiscence. There were no strut dehiscence cases identified in aortic prostheses. Table 1 details the corrected data demonstrating the influence of strut dehiscence on the freedom from structural valve deterioration with the Carpentier-Edwards supraannular porcine bioprosthesis.

References

1. Antretter H. Medtronic Intact porcine bioprosthesis [Letter]. Ann Thorac Surg 1996;62:940–1.[Free Full Text]
2. Antretter H, Cottogini M, Mueller LC, Mair P, Furtwaengler W, Moes N. Medtronic Intact bioprosthesis in aortic position: unexplained immediate degeneration. J Thorac Cardiovasc Surg 1993;106:1218–9.[Medline]
3. Vesely I. Analysis of the Medtronic Intact bioprosthetic valve. J Thorac Cardiovasc Surg 1991;101:90–9.[Abstract]
4. Lemieux MD, Jamieson WRE, Landymore RW, et al. Medtronic Intact porcine bioprosthesis: clinical performance to seven years. Ann Thorac Surg 1995;60:S258–63.[Medline]
5. Haverich A, Cremer J, Hirt SW, Keutel J. Early degeneration of a Medtronic Intact bioprosthesis in an aortic position. Eur J Cardiothorac Surg 1995;9:172.[Free Full Text]
6. Pellerin M, Mihaileanu S, Couëtil JP, et al. Carpentier-Edwards pericardial bioprosthesis in aortic position: long-term follow-up 1980 to 1994. Ann Thorac Surg 1995;60:S292–6.[Medline]
7. Jamieson WRE, Burr LH, Miyagishima RT, et al. Structural deterioration in Carpentier-Edwards standard and supraannular porcine bioprostheses. Ann Thorac Surg 1995;60:S241–7.[Medline]

This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Eric Jamieson, W. R. Search for Related Content PubMed PubMed Citation Articles by Eric Jamieson, W. R.