[Middle term follow-up and comparative study of valve replacement with four kinds of new model bovine pericardial xenografts].

Our early clinical experience (up to 4 year's follow-up) with four new pericardial xenografts were reviewed. During the period July 1983 to December 1986, 148 Ionescu-Shiley Pericardial Xenografts (ISL) in 130 patients, 68 Carpentier-Edwards pericardial xenografts (CEP) in 65, 32 Mitroflow pericardial xenografts (MF) in 29 and 36 Hancock pericardial xenografts (HP) in 29 have been implanted. The actuarial survival rates at 3.3 years are 89.9 +/- 2.7% for ISL, 92.3 +/- 3.3% for CEP, 93.1 +/- 4.7% for MF and 93.1 +/- 4.7% for HP. Fifteen cases of primary tissue failure (PTF) were caused in all groups but CEP. The actuarial free rates from PTF at 3.3 years were 92.9 +/- 2.4% for ISL, 100% for CEP, 95.5 +/- 4.4% for MF, 82.6 +/- 7.9% for HP. All bioprostheses explanted because of PTF showed commissural tears occurred at the top of the stent posts or at the edge of the stent. In this respect, it is the reason why the cases with CEP were free from PTF that CEP has been achieved to be improved its frame design. The incidences of prosthetic valve endocarditis were not different among these kinds of bioprosthetic valves. The free rates from thromboembolism at 3.3 years were 97.5 +/- 1.5% for ISL, 98.3 +/- 1.7% for CEP, 96.0 +/- 3.9% for MF and 88.7 +/- 6.1% for HP. There was no patient with CEP and MF suffered from thromboembolism with sinus rhythm. In comparison of these 4 valves, we conclude that CEP is useful clinically because of its satisfactory durability and antithrombogenicity.