The objective of this study was to investigate the late performance of the porcine bioprosthesis Carpentier-Edwards model with emphasis on all morbid and/or lethal events which could be related to its presence. One-hundred consecutive patients who underwent a mitral valve implant and 100 consecutive patients who underwent aortic valve implant were studied. The average tracking period for the former was 93 months and 62 months for the latter. Aproximately 80% of these patients remained alive during the follow-up time. The survival curves of patients who received mitral valve implant and patients who received aortic valve implant showed an initial decrease due to in-hospital mortality. Then, the curves stabilized showing another decrease about 5 to 6 years later, probably due to structural degeneration. Patients who needed reoperation to substitute the deteriorated bioprosthesis presented a higher mortality rate than those who did not need reoperation. Nevertheless, this difference had not statistic significance. Mortality related to the bioprosthesis was close to 5% either for patients with bioprosthesis in mitral or in aortic position. Among the 100 patients who received a mitral-position bioprosthesis, 22 needed reoperation to replace it, being the incidence of reoperation higher in those who were under 35 years of age at the time of the first operation. Yet, only 7 among those who received aortic-position bioprosthesis needed reoperation. The thromboembolic complications were rare with use of bioprosthesis although none of the patients received systemic oral anticoagulation. It was concluded that: 1) the use of Carpentier-Edwards porcine bioprosthesis presented satisfactory clinic results concerning in-hospital and late mortality rate, similar not only to other groups but also when other types of valve substitutes are used; 2) the structural deterioration is a remarkable event for patients who bear the bioprosthesis, starting basically 6 to 7 years after the implant; 3) the structural deterioration of the bioprosthesis modifies patient's fate causing, as a result, reoperation to substitute the implanted bioprosthesis. However, the occurance of such cases does not increase significantly mortality rate .
heart valves prostheses