Results of up to 9 years of high-temperature- fixed valvular bioprostheses in a young population

• Published in: The Annals of thoracic surgery Vol. 71; no. 5; pp. S353 - S355
• Main Authors: Berrebi, Alain J, Carpentier, Sophie M, Phuong, Phan Kim, Phan, Nguyen Van, Chauvaud, Sylvain M, Carpentier, Alain
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01.05.2001; Elsevier Science
• Subjects: Adolescent; Adult; Age Factors; Aortic Valve - surgery; Biological and medical sciences; Bioprosthesis; Cause of Death; Child; Child, Preschool; Female; Follow-Up Studies; Heart Valve Prosthesis; Humans; Infant; Male; Medical sciences; Mitral Valve - surgery; Postoperative Complications - mortality; Prosthesis Design; Prosthesis Failure; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Tissue Fixation; Human; Graft(material); Prognosis; Animal origin; Heterograft; Long term; Morbidity; Incidence; Graft failure; Pig; Prevention; Vertebrata; Biological fixation; Mammalia; Surgery; Young adult; Calcification; Graft; Biomaterial; Degeneration; Artiodactyla; Technique; Aortic valve; Ungulata
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/S0003-4975(01)02558-9

Background. Bioprosthetic valve replacement in young patients remains a controversial issue due to a high rate of early calcification. Previous studies in our laboratory have shown that high-temperature fixation of glutaraldehyde preserved bioprosthesis (HTF) mitigates calcification. The first clinical application of this technique was started in 1991. Methods. From January 1991 to September 1998, 50 patients in whom anticoagulants were contraindicated underwent single aortic valve replacement (n = 33) or mitral valve replacement (n = 17) using HTF bioprostheses. The age of the patients ranged from 7 months to 35 years (mean 22.7 ± 6.8 years). The mean New York Heart Association status was 2.4. Mean follow-up 4 years ± 1.8 for a total follow-up of 196 patient-years. Results. There were no operative deaths and but there were two late deaths, one valve related. Structural failure occured in 4 patients (2%/patient-year) requiring a reoperation in 3 patients (1.5%/patient-year). No endocarditis or thromboembolic episodes were observed. At late examination (June 2000), 46 patients (92%) were in New York Heart Association class I or II, with a well functioning valve. Conclusions. Replacement with HTF bioprostheses in young patients has demonstrated encouraging midterm results with a low incidence of structural failure