Long-term results of a stented bioprosthetic valve in the aortic position: structural valve deterioration and valve haemodynamic deterioration of bovine pericardial and porcine valves

• Published in: European journal of cardio-thoracic surgery 2023-02, Vol.63 (2)
• Main Authors: Jung, Yoo Jin, Choi, Jae Woong, Kang, Yoonjin, Kim, Ji Seong, Sohn, Suk Ho, Hwang, Ho Young, Kim, Kyung Hwan
• Format: Article
• Language: English
• Subjects: Animals; Aortic Valve - surgery; Bioprosthesis; Cattle; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation - methods; Hemodynamics; Prosthesis Design; Prosthesis Failure; Swine; Treatment Outcome
• ISSN: 1873-734X; 1873-734X
• DOI: 10.1093/ejcts/ezac506

This study compared the clinical outcomes of bovine and porcine bioprosthetic valves based on structural valve deterioration (SVD) and valve haemodynamic deterioration (VHD) in the aortic position. From January 1995 to December 2014, patients who underwent aortic valve replacement (AVR) using a bovine pericardial valve or porcine valve were enrolled. SVD and VHD were defined according to the mean transprosthetic gradient and the grade of aortic regurgitation on transthoracic echocardiography. The propensity score matching was used to adjust for differences in preoperative and operative characteristics. A total of 520 patients were enrolled. Of these, 372 patients underwent AVR using a bovine pericardial valve and 148 patients underwent AVR using a porcine valve. Then, 135 pairs of patients were extracted after propensity score matching. The median follow-up duration was 8.2 years (interquartile range, 5.4-11.3). Among the matched patients, no significant differences occurred in overall survival (survival at 10 years: 64.7% vs 70.9%) or cardiac death (cumulative incidence at 10 years: 14.2% vs 13.1%) between the 2 groups. The cumulative incidence of moderate or greater SVD and VHD was significantly higher in the porcine valve group than in the bovine valve group (SVD at 10 years-porcine: 29.8% vs bovine: 13%; VHD at 10 years-porcine: 19.8% vs bovine: 3.8%, respectively). However, no significant differences were noted in the cumulative incidence of severe SVD and severe VHD between the 2 groups. The bovine pericardial valve should be considered in AVR because the cumulative incidences of moderate or greater SVD and VHD were significantly lower than those of the porcine valve.