Aortic valve replacement with the composite Labcor (TM) porcine bioprosthesis in the elderly

Background. This paper presents the analysis of clinical results of the com posite porcine Labcor(TM) bioprosthesis in the replacement of aortic valves in the elderly. Methods. This retrospective study was carried out in the Thoracic and Cardi ovascular Surgical Department, La Pitie-Salpetriere Hospital, Paris, for re placement of calcified, stenosed aortic valves between 1988 and 1995. It in volved a series of 100 patients aged 70 and over (mean: 80 +/-5 years rangi ng from 70 to 90). There were 63 female and 37 male patients. Preoperativel y, five patients were in NYHA Class I, 23 in Class II, 65 in Class III and 7 in Class IV. Results. Fifteen patients died in the early postoperative stage and 13 duri ng the follow-up period. There was no evidence of valve failure. The averag e follow-up was 32 months and the actuarial survival rate at 5 years was 74 +/-5%. Complications due to bleeding occurred in 3 patients taking anticoa gulant treatment. There were neither valvular thrombosis nor embolism. Two patients presented with prosthetic endocarditis. Two patients received a re operation because of leakage (I septic). The five-year follow-up showed tha t 96% of patients did not require further surgery. When this study was comp leted, 83% of patients were in Class I or II versus 71% in Class III or IV prior to surgery. Conclusions. In the early/middle follow-up term, the results obtained when replacing the aortic valve with the composite Labcor(TM) bioprosthesis in t he elderly are satisfying. Nevertheless, further long-term assessment is ne eded.