Comparison of porcine valve xenografts with mechanical prostheses. A 7 1/2 year experience.

A total of 479 valve replacements were performed in 469 patients for aortic, mitral, and tricuspid disease. A total of 529 valves were implanted (311 Carpentier-Edwards, 118 Hancock, 94 Björk-Shiley, and six other mechanical valves). Of the 479 operations, 51.1% (245) were carried out in male patients and 48.9% (234) were carried out in female patients. The mean age was 57.6 years; however, 28.6% (137) of the operations were performed in patients over 65 years of age. One hundred five patients (21.9%) had had previous cardiac operations of one type or another. Follow-up was 99.6% and the average length of follow-up was 36.2 months. The overall operative mortality was 5.6%. The operative mortality in the isolated aortic valve replacement group was 2.0% and that in the mitral valve replacement group, 4.4%. There was a 5.9% valve explant rate in the Hancock series; however, no valve explants were required because of valve dysfunction in either the Carpentier-Edwards or the Björk-Shiley groups. The thromboembolic rate in the aortic valve position was 2.4, 1.1, and 2.1 emboli per 100 patient-years in the Hancock, Carpentier-Edwards, and Björk-Shiley groups, respectively. The thromboembolic rate in the mitral valve position was 2.8, 2.2, and 1.0 emboli per 100 patient-years in the Hancock, Carpentier-Edwards, and Björk-Shiley groups, respectively.