Bioprosthetic heart valve replacement: cumulative experience of 3 cardiac surgery centers in Russia

We analysed log-term results of mitral (MVR), tricuspid (TVR) and aortic (AVR) valve replacement with epoxy-treated bioprostheses «KemCor» and «PeriCor» (965 patients, undergone surgery in 1991 -2005). Age younger than 18 was an exclusion criterion. All in all, there were 1047 implantations: 713 (68%) MVR, 315 (30%) TVR, 19 (2%) AVR. Average follow-up time was 4.1 years. Actuarial survival in 9 year of follow-up was 70%, freedom od reoperation due to prosthetic valve dysfunction was 60%. Dominant causes of dysfunction were prosthetic endocarditis (52%), primary tissue deterioration with calcification (19.6%) and the one with calcification (18.5%). Evident differences between the centers in complication rate and structure referred mainly to different approaches towards usage of bioprosthetic valves: inaccuracies in postoperative patient management at outpatient clinics are shown to negatively affect the long-term results. According to this, we see the necessity of National Standards development the for management of patients with implanted bioprosthetic heart valves.