Comparison of reoperation findings of the Carpentier-Edwards (standard) bioprosthesis and the St Jude bioimplant (formerly Liotta) in the mitral position

Between 1986 and 1996, 50 patients with Carpentier-Edwards porcine bioprost heses and 211 with a St Jude bioprosthesis underwent reoperation because of structural valve deterioration. Structural valve deterioration was defined as an intrinsic abnormality of the prosthesis (leaflet disruption, calcifi cation, leaflet thickening, etc.) that caused stenosis or regurgitation fou nd on physical examination and echocardiography. Fifteen of the Carpentier- Edwards bioprosthesis group were male and 35 were female. Eighty-two of the St Jude group were male and 129 female, The mean age at reoperation was 33 .88 +/- 10.31 years (range 19-70) for the Carpentier-Edwards group and 39.0 3 +/- 9.97 years (range 20-70) for the St Jude group. The average duration was 94.32 +/- 3.83 months for the Carpentier-Edwards group and 73.76 +/- 1. 44 months for the St Jude group (P < 0.001). The mean aortic cross-clamp ti me was 67.4 min (minimum 32, maximum 210) for the St Jude group and 63.21 m in (minimum 36, maximum 230) for the Carpentier-Edwards group. Reoperative hospital mortality was 10% (5/50) in the Carpentier-Edwards group and 7.1% (15/211) in the St Jude group (P > 0.05). Late failure modes of the biopros theses were defined for the purposes of this study as calcification, stenos is and torn leaflets. Of the Carpentier-Edwards group, seven patients (14%) developed calcification, six patients (12%) developed stenosis and 13 pati ents (26%) developed leaflet tears. Of the St Jude group, the incidences we re 22 patients (10%), 67 patients (31.8%) and 87 patients (41%), respective ly. This study indicates that the Carpentier-Edwards bioprosthesis is more durable than the St Jude, The St Jude bioprosthesis tended to develop leafl et tears and linear calcification in female patients, and nodular calcifica tion in male patients. (C) 1999 Published by Elsevier Science Ltd on behalf of The International Society for Cardiovascular Surgery. All rights reserv ed.