Mitral valve replacement with XXXX preserved aortic allografts.

@entity1 @entity712 @entity627 @entity3584 @entity886 @entity1031 @entity453 @entity337 @entity299 @entity583 @entity884
OBJECTIVE: To present long-term results after mitral valve replacement with stent mounted @entity3584 preserved aortic allografts in @entity1 older than 15 years. The clinical support for this study was to combine the @entity3584 technique of biological tissue preservation with the advantages of allografts when compared to xenografts. This was demonstrated in previous studies using other methods of tissue processing. METHODS: Between September 1984 and November 1994, 70 @entity1 aged 16-77 years (mean 35.4 years) underwent mitral valve replacement with this preserved and mounted allograft. Of these, 40 @entity1 (57.2%) were aged 16-35 years and 15 (21.4%) were 20 years old or younger; 46 (65.7%) were females and 24 (34.3%) males. Single mitral valve replacement was performed in 60 @entity1 and 10 were also subjected to other combined cardiac procedures. @entity1 aortic valves were obtained during routine autopsy, processed in @entity3584 and mounted into flexible stents, using the same technique as that used for porcine bioprostheses. RESULTS: Hospital mortality was 1.4%. Total follow-up was 543.1 @entity1 -years, corresponding to a mean follow-up of 7.9 years per @entity1 . Echocardiography demonstrated a hemodynamic performance similar to porcine bioprostheses. Late mortality was 0.7 +/- 0.6% per @entity1 -year and the causes were @entity712 in 2, @entity884 in 1 and @entity583 in 1. The 12-year actuarial survival was 92.4 +/- 3.2%. The incidence of late complications was 5.2 +/- 1.2% per @entity1 -year, including @entity712 , @entity884 , periprosthetic leak, @entity1031 episodes, recurrence of @entity627 , @entity453 and allograft failure. Complications related to @entity299 represented 2.8 +/- 0.6% and allobioprosthesis-related 2.4 +/- 0.5% per @entity1 -year. The 12-year actuarial freedom from @entity712 was 81.0 +/- 15.0%. The incidence of reoperations was 1.5 +/- 0.8% per @entity1 -year and the main indication was @entity884 . Other causes were periprosthetic leak, @entity337 in the native @entity886 . Functional results demonstrated a significant improvement in @entity1 clinical condition. CONCLUSION: This 12-year follow-up shows a very low incidence of primary allograft failure for @entity1 older than 15 years undergoing mitral valve replacement, and much superior than our results with porcine bioprosthesis in the same age group. This supports our assumption that this investigational valve represents a new advance in cardiac valve surgery.
