Early and Mid-Term Outcome of Valve Replacement With Porcine Bioprosthesis in the Aortic Positions

OBJECTIVES: The porcine bioprosthesis is used for the replacement of malfunctioning native or prosthetic aortic and/or mitral heart valves. This study aimed to retrospectively analyze the early and mid-term clinical results of porcine bioprosthesis in the aortic position among the Chinese population.

METHODS: Patients who underwent aortic valve replacement (AVR) with the porcine bioprosthesis at two tertiary care centers from April 2017 to October 2021 were included. The medical records were retrospectively reviewed to evaluate the clinical characteristics, operative findings, and early and mid-term postoperative outcomes in these patients.

RESULTS: The study population consisted of 127 patients (78 males, mean age 64 ± 9 years), with a mean preoperative New York Heart Association (NYHA) class of 2.8 ± 0.6. There were no valve-related reoperations or deaths during the perioperative period. The follow-up rate was 98.4%, with a cumulative follow-up duration of 308 person-years. During follow-up, the incidence of prosthetic valve dysfunction and perivalvular leakage events was both 0.32%/patient-year, with no reoperations required. Other observed adverse events included arrhythmias (1.62%/patient-year), cerebral hemorrhage (0.32%/patient-year), cerebral embolism (0.32%/patient-year), and cerebral infarction (0.32%/patient-year). Nine deaths were recorded, and the cumulative survival rate at four years was 90.1% ± 3.6%. The causes of death included cerebral hemorrhage (2 cases), tumor metastasis (1 case), other cerebrovascular causes (1 case), renal failure (1 case), hypertension (1 case), and unknown etiology (2 cases). Subgroup analysis showed a four-year cumulative survival rate of 97.7% ± 2.3% for patients under 65 years and 83.6% ± 6.1% for those aged 65 years or older (P > 0.05).

CONCLUSIONS: The porcine bioprosthesis demonstrated favorable early and mid-term clinical outcomes with a minimal incidence of valve degeneration and adverse events. It is one of the reliable options for patients undergoing heart valve replacement.