Results of up to 9 years of high-temperature-fixed valvular bioprostheses in a young population

Background. Bioprosthetic valve replacement in young patients remains a con troversial issue due to a high rate of early calcification. Previous studie s in our laboratory have shown that high-temperature fixation of glutaralde hyde preserved bioprosthesis (HTF) mitigates calcification. The first clini cal application of this technique was started in 1991. Methods. From January 1991 to September 1998, 50 patients in whom anticoagu lants were contraindicated underwent single aortic valve replacement (n = 3 3) or mitral valve replacement (n = 17) using HTF bioprostheses. The age of the patients ranged from 7 months to 35 years (mean 22.7 +/- 6.8 years). T he mean New York Heart Association status was 2.4. Mean follow-up 4 years /- 1.8 for a total follow-up of 196 patient-years. Results. There were no operative deaths and but there were two late deaths, one valve related. Structural failure occured in 4 patients (2%/patient-ye ar) requiring a reoperation in 3 patients (1.59%/patient-year). No endocard itis or thromboembolic episodes were observed. At late examination (Tune 20 00), 46 patients (92%) were in New York Heart Association class I or II, wi th a well functioning valve. Conclusions. Replacement with HTF bioprostheses in young patients has demon strated encouraging midterm results with a low incidence of structural fail ure (C) 2001 by The Society of Thoracic Surgeons.