MECHANICAL VERSUS BIOLOGICAL VALVE PROSTHESIS - A 10-YEAR COMPARISON REGARDING FUNCTION AND QUALITY-OF-LIFE

To determine the long-term outcome of biological and mechanical heart valve prostheses, we compared the Biocor, a new generation of porcine bioprosthesis, with the St. Jude Medical mechanical prosthesis. One hu ndred consecutive patients operated on between 1983 and 1985 with the Biocor in the aortic, mitral, or both positions (without concomitant c ardiac procedures) were followed until January 1993, together with 100 matched patients implanted with the St. Jude valve. The mean age was 66 and 67 years, respectively. The follow-up was 100% complete. Valve- related mortality differed significantly, with a freedom rate of 80.7% +/- 9.0% for the St. Jude group and 97.7% +/- 1.6% for the Biocor gro up. There were few thromboembolic events, with no significant differen ce between the groups. Anticoagulant-related hemorrhage occurred almos t exclusively in the St. Jude group (2.3%/patient-year), and reoperati ons were required almost exclusively in the Biocor group (1.8%/patient -year). The occurrence of all valve-related complications (mortality p lus morbidity) differed markedly, with an actuarial freedom at 10 year s of 55.8% +/- 9.8% for St. Jude and 80.0% +/- 4.4% for the Biocor. Qu ality of life and echocardiographic measurements did not differ signif icantly between the groups. We conclude from this study that the long- term performance of the Biocor and St. Jude are comparable, even thoug h valve-related complications tended to be fewer in the Biocor group, with a significantly fewer incidence of valve-related death.