Background and aim of the study: The study aim was to describe patterns of failure in a consecutive series of patients with the CryoLife-O'Brien stentless porcine aortic bioprosthesis.
Methods: The records of patients requiring redo surgery were reviewed. All surviving patients were contacted and questioned about clinical events since implantation of the valve.
Results: The early mortality was 7%, whilst 4% of patients died between 30 days and one year after surgery, and 31% died beyond one year. Six cases of structural deterioration were identified; five of these cases were due to a cusp tear (usually of the right coronary cusp), and one case was due to valve calcification. There were five cases of non-structural dysfunction; dehiscence was present in three of these cases, with progression of minor periprosthetic regurgitation seen immediately after surgery. Three failures occurred as a result of infective endocarditis. Structural valve deterioration or dehiscence occurred at a mean of 52 months after surgery, with no step-up in incidence at any time-point. Primary failure occurred in three of 49 (6%) bioprostheses manufactured after June 2003, and in eight of 117 (7%) manufactured before June 2003.
Conclusion: The incidence of primary valve failure at 52 months after implantation was found to be 7%. It is suggested that routine echocardiography be performed at least annually, particularly in those patients with even minor paraprosthetic regurgitation on the postoperative study.